Meme Kanserinde Aksilla Negatif Olgularý Doðru Belirlemek Ýçin En Az 10 Lenf Nodu Çýkarýlmasý Yeterli midir?

Background: The aim of this study is to determine the minimum number of lymph nodes that confidently represents the complete axilla in an axillary dissection. Methods: The medical records of 411 patients vvith early breast cancer treated betvveen October 1999 andAugust 2002 were evaluated retrospectively. Total number of axillary lymph nodes removed, number of metastatic nodes, tumoursize, grade, and presence of lymphovascular invasion were revievved. Results: Axillary node metastases were detected in 60% of patients. The mean number of nodes collected was 20.2±0.4, vvith a mean of 3.6 ± 0.3 metastatic nodes. There was a significant difference in terms of the rate of metastatic nodes betvveen the patients vvith 6-15 nodes removed and those vvith 16 or more removed, 45% and 78%, respectively. The highest rate of metastatic nodes was determined in patients vvith 16-20 nodes removed (68%). The rate of axillary metastasis was not higher in group vvith more than 20 nodes removed. Conclusions: Although it is generaiiy considered that minimum 10 lymph nodes should be removed in an axillary dissectin to confidently determine the patients vvith breast cancer who had negative axiiiary node status, according to the results of this study, hovvever, it might be stated that the number of lymph nodes collected should be minimum 16.

Is Minimum 10 Nodes Removed to Correctly Determine The Breast Cancer Patients Who Had Negative Axillary Status Sufficient?

Arka Plan: Bu çalýþmanýn amacý, aksiller disseksiyonda tüm aksillayý güvenli bir þekilde temsil edecek minimum lenf nodu sayýsýný beiiriemektir. Yöntem: Ekim 1999-Aðustos 2002 tarihleri arasýnda tedavi edilen 411 erken evre meme kanserli hastanýn kayýtlarý retrospektif olarak deðerlendirildi. Çýkarýlan toplam aksiller lenf nodu sayýsý, metastatik lenf nodu sayýsý, tümör boyutu, grad ve lenfovasküler invazyon varlýðý incelendi. Bulgular: Hastalarýn %60’ýnda aksiller lenf nodu metastazý saptandý. Çýkarýlan ortalama lenf nodu sayýsý 20.2 ± 0.4, metastatik lenf nodu sayýsý ise 3.6 ± 0.3 olarak bulundu. Aksillasýndan toplam 6-15 lenf nodu ile 16 ve üzeri lenf nodu disseke edilen hastalar arasýnda metastatik lenf nodu oraný bakýmýndan anlamlý fark olduðu tespit edildi (sýrasýyla %45 ve %78). En yüksek aksiller metastaz oraný, 16-20 lenf nodu çýkarýlan hastalarda saptandý (%68). Yirmi’den fazla lenf nodu çýkarýlan grupta aksiller metastaz oraný daha yüksek deðildi. Sonuçlar: Genel olarak aksi Ýlasý negatif meme kanserli hastalarý güvenle belirlemek için, aksiller disseksiyonla minimum 10 lenf nodu çýkarýlmasý gerektiði kabul edilmekle beraber, bu çalýþmanýn sonuçlarýna göre bu sayýnýn en az 16 olmasý gerektiði ileri sürülebilir.