inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2024-9-4-120-125inovmed-996Research ArticleОБЗОРЫREVIEWSОбзор современных подходов видеоассистированной эндоскопической биопсии сигнальных лимфатических узлов и аксиллярной лимфодиссекцииModern Endoscopic Approaches to Video-Assisted Sentinel Lymph Node Biopsy and Axillary Lymph Node Dissection: A Reviewhttps://orcid.org/0000-0003-3348-4251АхмедовР. М.AkhmedovR. M.

Ахмедов Руслан Мерзиалиевич - врач-онколог, Клиника высоких медицинских технологий им. Н.И. Пирогова, СПбГУ; аспирант кафедры онкологии, детской онкологии и лучевой терапии, СПбГПМУ.

Санкт-Петербург

Ruslan M. Akhmedov - Oncologist, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University; Postgraduate Student, Department of Oncology, Pediatric Oncology and Radiation Therapy, Saint Petersburg State Pediatric Medical University.

Saint Petersburg

https://orcid.org/0000-0001-9650-7305КонстантиноваВ. В.KonstantinovaV. V.

Константинова Валерия Валерьевна - врач-онколог, Клиника высоких медицинских технологий им. Н.И. Пирогова.

Санкт-Петербург

Valeria V. Konstantinova - Oncologist, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

https://orcid.org/0009-0000-0450-0166ВацА. Б.VatsA. B.

Вац Анна Борисовна - врач-онколог, Клиника высоких медицинских технологий им. Н.И. Пирогова.

Санкт-Петербург

Anna B. Vats - Oncologist, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

https://orcid.org/0009-0004-7511-2952ЖуровА. С.ZhurovA. S.

Журов Александр Сергеевич - врач-онколог, Клиника высоких медицинских технологий им. Н.И. Пирогова.

Санкт-Петербург

Aleksandr S. Zhurov - Oncologist, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

https://orcid.org/0000-0001-5706-250XСемилетоваЮ. В.SemiletovaYu. V.

Семилетова Юлия Вадимовна - к. м. н., врач-онколог, Клиника высоких медицинских технологий им. Н.И. Пирогова.

Санкт-Петербург

Yulia V. Semiletova - Cand. Sci. (Med.), Oncologist, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

https://orcid.org/0009-0007-3112-8081ОлчоноваА. А.OlchonovaA. A.

Олчонова Алина Алексеевна - врач-онколог, Клиника высоких медицинских технологий им. Н.И. Пирогова.

Санкт-Петербург

Alina A. Olchonova - Oncologist, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

https://orcid.org/0000-0002-2274-8170БелоусовА. М.BelousovA. M.

Белоусов Александр Михайлович - к. м. н., врач-хирург, врач-онколог, заместитель директора по медицинской части (хирургия и онкология).

Санкт-Петербург

Aleksandr M. Belousov - Cand. Sci. (Med.), Surgeon, Oncologist, Deputy Director for Medical Affairs (Surgery and Oncology), N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

https://orcid.org/0000-0001-7582-618XБит-СаваЕ. М.Bit-SavaE. M.

Бит-Сава Елена Михайловна - д. м. н., профессор кафедры онкологии, детской онкологии и лучевой терапии, СПбГПМУ; врач-онколог, заведующая отделением опухолей молочной железы, СПб КНпЦСВМП(о) им. Н.П. Напалкова.

197758, Санкт-Петербург, посёлок Песочный, ул. Ленинградская, д. 68А

Elena M. Bit-Sava - Dr. Sci. (Med.), Professor at the Department of Oncology, Pediatric Oncology and Radiation Therapy, Saint Petersburg State Pediatric Medical University; Oncologist, Head of the Division of Breast Tumors, Saint Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncological) named after N.P. Napalkov.

ulitsa Leningradskaya 68A, poselok Pesochnyi, Saint Petersburg, 197758

bit-sava@mail.ruhttps://orcid.org/0000-0001-6183-9764ДашянГ. А.DashyanG. A.

Дашян Гарик Альбертович - д. м. н., врач-онколог, заведующий онкологическим отделением № 1, Клиника высоких медицинских технологий им. Н.И. Пирогова.

Санкт-Петербург

Garik A. Dashyan - Dr. Sci. (Med.), Oncologist, Head of the Oncology Unit No. 1, N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University.

Saint Petersburg

Клиника высоких медицинских технологий им. Н.И. Пирогова, Санкт-Петербургский государственный университет; Санкт-Петербургский государственный педиатрический медицинский университетРоссияN.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University; Saint Petersburg State Pediatric Medical UniversityRussian FederationКлиника высоких медицинских технологий им. Н.И. Пирогова, Санкт-Петербургский государственный университетРоссияN.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State UniversityRussian FederationСанкт-Петербургский государственный педиатрический медицинский университет; Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический) им. Н.П. НапалковаРоссияSaint Petersburg State Pediatric Medical University; Saint Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncological) named after N.P. NapalkovRussian Federation20243012202404120125Copyright © Ахмедов Р.М., Константинова В.В., Вац А.Б., Журов А.С., Семилетова Ю.В., Олчонова А.А., Белоусов А.М., Бит-Сава Е.М., Дашян Г.А., 20242024Ахмедов Р.М., Константинова В.В., Вац А.Б., Журов А.С., Семилетова Ю.В., Олчонова А.А., Белоусов А.М., Бит-Сава Е.М., Дашян Г.А.Akhmedov R.M., Konstantinova V.V., Vats A.B., Zhurov A.S., Semiletova Y.V., Olchonova A.A., Belousov A.M., Bit-Sava E.M., Dashyan G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/996

Целью данной статьи является анализ современных эндоскопических методик биопсии сигнальных лимфатических узлов и аксиллярной лимфодиссекции в хирургическом лечении рака молочной железы.

С помощью эндоскопических методов значительно расширились возможности хирургии рака молочной железы за счет более точной диагностики, уменьшения травматичности операций, и, соответственно, снижения рисков для пациентов.

В обзоре рассматриваются основные техники, используемые при эндоскопическом подходе к биопсии сигнальных лимфатических узлов и аксиллярной лимфодиссекции, анализируются эффективность и безопасность, а также их сравнительные преимущества в отношении традиционных открытых методов.

В статье обсуждаются результаты последних исследований, касающихся точности диагностики и частоты осложнений. Кроме того, рассматривается влияние эндоскопической аксиллярной лимфодиссекции на прогноз и качество жизни пациентов с раком молочной железы.

This article aims to analyze modern endoscopic techniques of sentinel lymph node biopsy and axillary lymph node dissection in breast cancer surgery.

Owing to more accurate diagnosis and minimized patient morbidity and risks, endoscopic techniques have significantly expanded capabilities of breast cancer surgery.

We review the main endoscopic techniques of sentinel lymph node biopsy and axillary lymph node dissection, analyze their efficacy and safety, and compare their benefits with those of conventional open techniques.

The article discusses results of recent studies regarding diagnostic accuracy and complication rates. Furthermore, we discuss the impact of endoscopic axillary lymph node dissection on the prognosis and quality of life in patients with breast cancer.

эндоскопиябиопсия сигнальных лимфоузловдиссекция подмышечных лимфоузловрак молочной железыонкологияendoscopysentinel lymph node biopsyaxillary lymph node dissectionbreast cancercancerReferencesGradishar WJ, Moran MS, Abraham J, et al. NCCN Guide-lines® Insights: Breast Cancer, Version 4.2023. J Natl Compr Canc Netw. 2023;21(6):594–608. PMID: 37308117. https://doi.org/10.6004/jnccn.2023.0031Gradishar WJ, Moran MS, Abraham J, et al. NCCN Guide-lines® Insights: Breast Cancer, Version 4.2023. J Natl Compr Canc Netw. 2023;21(6):594–608. PMID: 37308117. https://doi.org/10.6004/jnccn.2023.0031Keelan S, Flanagan M, Hill ADK. Evolving trends in surgical management of breast cancer: an analysis of 30 years of practice changing papers. Front Oncol. 2021;11:622621. PMID: 34422626. PMCID: PMC8371403. https://doi.org/10.3389/fonc.2021.622621Keelan S, Flanagan M, Hill ADK. Evolving trends in surgical management of breast cancer: an analysis of 30 years of practice changing papers. Front Oncol. 2021;11:622621. PMID: 34422626. PMCID: PMC8371403. https://doi.org/10.3389/fonc.2021.622621Lin AP, Huang TW, Tam KW. Treatment of male breast cancer: meta-analysis of real-world evidence. Br J Surg. 2021;108(9):1034– 1042. PMID: 34476472. https://doi.org/10.1093/bjs/znab279Lin AP, Huang TW, Tam KW. Treatment of male breast cancer: meta-analysis of real-world evidence. Br J Surg. 2021;108(9):1034– 1042. PMID: 34476472. https://doi.org/10.1093/bjs/znab279Cao S, Liu X, Cui J, et al. Feasibility and reliability of sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer patients with positive axillary nodes at initial diagnosis: an up-to-date meta-analysis of 3,578 patients. Breast. 2021;59:256– 269. PMID: 34325383. PMCID: PMC8334738. https://doi.org/10.1016/j.breast.2021.07.015Cao S, Liu X, Cui J, et al. Feasibility and reliability of sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer patients with positive axillary nodes at initial diagnosis: an up-to-date meta-analysis of 3,578 patients. Breast. 2021;59:256– 269. PMID: 34325383. PMCID: PMC8334738. https://doi.org/10.1016/j.breast.2021.07.015Bharath S, Sharma D, Yadav SK, Shekhar S, Jha CK. A systematic review and meta-analysis of touch imprint cytology and frozen section biopsy and their comparison for evaluation of sentinel lymph node in breast cancer. World J Surg. 2023;47(2):478–488. PMID: 36310323. https://doi.org/10.1007/s00268-022-06800-wBharath S, Sharma D, Yadav SK, Shekhar S, Jha CK. A systematic review and meta-analysis of touch imprint cytology and frozen section biopsy and their comparison for evaluation of sentinel lymph node in breast cancer. World J Surg. 2023;47(2):478–488. PMID: 36310323. https://doi.org/10.1007/s00268-022-06800-wJiang Y, Li J, Chen B, et al. Sentinel lymph node biopsy mapped with carbon nanoparticle suspensions in patients with breast cancer: a systematic review and meta-analysis. Front Oncol. 2022;12:818812. PMID: 35419285. PMCID: PMC8995566. https://doi.org/10.3389/fonc.2022.818812Jiang Y, Li J, Chen B, et al. Sentinel lymph node biopsy mapped with carbon nanoparticle suspensions in patients with breast cancer: a systematic review and meta-analysis. Front Oncol. 2022;12:818812. PMID: 35419285. PMCID: PMC8995566. https://doi.org/10.3389/fonc.2022.818812Chen Y, Xu J, Liang Y, Zeng X, Xu S. A challenging therapeutic method for breast cancer: non-lipolytic endoscopic axillary surgery through periareolar incisions. Oncol Lett. 2020;19(6):4088–4092. PMID: 32382347. PMCID: PMC7202305. https://doi.org/10.3892/ol.2020.11501Chen Y, Xu J, Liang Y, Zeng X, Xu S. A challenging therapeutic method for breast cancer: non-lipolytic endoscopic axillary surgery through periareolar incisions. Oncol Lett. 2020;19(6):4088–4092. PMID: 32382347. PMCID: PMC7202305. https://doi.org/10.3892/ol.2020.11501Sanders SB, Hoskin TL, Stafford AP, Boughey JC. Factors influencing non-sentinel lymph node involvement in patients with positive sentinel lymph node(s) after neoadjuvant chemotherapy for breast cancer. Ann Surg Oncol. 2022;29(12):7769–7778. PMID: 35834142. https://doi.org/10.1245/s10434-022-12064-4Sanders SB, Hoskin TL, Stafford AP, Boughey JC. Factors influencing non-sentinel lymph node involvement in patients with positive sentinel lymph node(s) after neoadjuvant chemotherapy for breast cancer. Ann Surg Oncol. 2022;29(12):7769–7778. PMID: 35834142. https://doi.org/10.1245/s10434-022-12064-4Elshanbary AA, Awad AA, Abdelsalam A, et al. The diagnostic accuracy of intraoperative frozen section biopsy for diagnosis of sentinel lymph node metastasis in breast cancer patients: a meta-analysis. Environ Sci Pollut Res Int. 2022;29(32):47931– 47941. PMID: 35543788. PMCID: PMC9252966. https://doi.org/10.1007/s11356-022-20569-4Elshanbary AA, Awad AA, Abdelsalam A, et al. The diagnostic accuracy of intraoperative frozen section biopsy for diagnosis of sentinel lymph node metastasis in breast cancer patients: a meta-analysis. Environ Sci Pollut Res Int. 2022;29(32):47931– 47941. PMID: 35543788. PMCID: PMC9252966. https://doi.org/10.1007/s11356-022-20569-4Barrio AV, Montagna G, Mamtani A, et al. Nodal recurrence in patients with node-positive breast cancer treated with sentinel node biopsy alone after neoadjuvant chemotherapy-a rare event. JAMA Oncol. 2021;7(12):1851–1855. PMID: 34617979. PMCID: PMC8498932. https://doi.org/10.1001/jamaoncol.2021.4394Barrio AV, Montagna G, Mamtani A, et al. Nodal recurrence in patients with node-positive breast cancer treated with sentinel node biopsy alone after neoadjuvant chemotherapy-a rare event. JAMA Oncol. 2021;7(12):1851–1855. PMID: 34617979. PMCID: PMC8498932. https://doi.org/10.1001/jamaoncol.2021.4394Hartmann S, Kühn T, Hauptmann M, et al; Die AXSANA-Studiengruppe. Axillary staging after neoadjuvant chemotherapy for initially node-positive breast carcinoma in germany: initial data from the AXSANA study. Geburtshilfe Frauenheilkd. 2022;82(9):932–940. PMID: 36110892. PMCID: PMC9470287. https://doi.org/10.1055/a-1889-7883Hartmann S, Kühn T, Hauptmann M, et al; Die AXSANA-Studiengruppe. Axillary staging after neoadjuvant chemotherapy for initially node-positive breast carcinoma in germany: initial data from the AXSANA study. Geburtshilfe Frauenheilkd. 2022;82(9):932–940. PMID: 36110892. PMCID: PMC9470287. https://doi.org/10.1055/a-1889-7883Yao CC, Liu C, Xian J. Comparison of single-pore nonliposuction near-infrared laparoscopy with conventional open surgery for axillary sentinel lymph node biopsy in patients with early breast cancer: a single-center, small-sample retrospective study. World J Surg Oncol. 2023;21(1):66. PMID: 36849976. PMCID: PMC9972847. https://doi.org/10.1186/s12957-023-02942-wYao CC, Liu C, Xian J. Comparison of single-pore nonliposuction near-infrared laparoscopy with conventional open surgery for axillary sentinel lymph node biopsy in patients with early breast cancer: a single-center, small-sample retrospective study. World J Surg Oncol. 2023;21(1):66. PMID: 36849976. PMCID: PMC9972847. https://doi.org/10.1186/s12957-023-02942-wLiang Y, Xu S. Nonliposuction Endoscopic sentinel lymph node biopsy through the periareolar incision. Surg Innov. 2020;27(6):570–579. PMID: 32687735. https://doi.org/10.1177/1553350620942983Liang Y, Xu S. Nonliposuction Endoscopic sentinel lymph node biopsy through the periareolar incision. Surg Innov. 2020;27(6):570–579. PMID: 32687735. https://doi.org/10.1177/1553350620942983Serra-Mestre JM, Fernandez Peñuela R, DʼAndrea F, Viñals JM, Serra-Renom JM. Endoscopic delayed breast reconstruction with expanders and implants via the axillary incision made for sentinel lymph node biopsy or lymphadenectomy. Ann Plast Surg. 2018;80(2):100–103. PMID: 28930777. https://doi.org/10.1097/SAP.0000000000001208Serra-Mestre JM, Fernandez Peñuela R, DʼAndrea F, Viñals JM, Serra-Renom JM. Endoscopic delayed breast reconstruction with expanders and implants via the axillary incision made for sentinel lymph node biopsy or lymphadenectomy. Ann Plast Surg. 2018;80(2):100–103. PMID: 28930777. https://doi.org/10.1097/SAP.0000000000001208Wang ZH, Gang TR, Wu SS, et al. Single-port endoscopic-sentinel lymph node biopsy combined with indocyanine green and carbon nanoparticles in breast cancer. Surg Endosc. 2023;37(10):7591– 7599. PMID: 37460818. PMCID: PMC10520094. https://doi.org/10.1007/s00464-023-10018-9Wang ZH, Gang TR, Wu SS, et al. Single-port endoscopic-sentinel lymph node biopsy combined with indocyanine green and carbon nanoparticles in breast cancer. Surg Endosc. 2023;37(10):7591– 7599. PMID: 37460818. PMCID: PMC10520094. https://doi.org/10.1007/s00464-023-10018-9Liu J, He G, Zhang Y, et al. Feasibility analysis of treating breast cancer patients with breast-conserving surgery via a periareolar incision combined with non-lipolytic suspension-type mastoscopy. Sci Rep. 2023;13(1):12129. PMID: 37495629. PMCID: PMC10372002. https://doi.org/10.1038/s41598-023-39199-yLiu J, He G, Zhang Y, et al. Feasibility analysis of treating breast cancer patients with breast-conserving surgery via a periareolar incision combined with non-lipolytic suspension-type mastoscopy. Sci Rep. 2023;13(1):12129. PMID: 37495629. PMCID: PMC10372002. https://doi.org/10.1038/s41598-023-39199-yKim SH, Park S, Kim SJ, Hur MH, Lee BG, Han MS. Self-management needs of breast cancer survivors after treatment: results from a focus group interview. Cancer Nurs. 2020;43(1):78–85. PMID: 30148729. https://doi.org/10.1097/NCC.0000000000000641Kim SH, Park S, Kim SJ, Hur MH, Lee BG, Han MS. Self-management needs of breast cancer survivors after treatment: results from a focus group interview. Cancer Nurs. 2020;43(1):78–85. PMID: 30148729. https://doi.org/10.1097/NCC.0000000000000641Du J, Liang Q, Qi X, et al. Endoscopic nipple sparing mastectomy with immediate implant-based reconstruction versus breast conserving surgery: a long-term study. Sci Rep. 2017;7:45636. PMID: 28361955. PMCID: PMC5374499. https://doi.org/10.1038/srep45636Du J, Liang Q, Qi X, et al. Endoscopic nipple sparing mastectomy with immediate implant-based reconstruction versus breast conserving surgery: a long-term study. Sci Rep. 2017;7:45636. PMID: 28361955. PMCID: PMC5374499. https://doi.org/10.1038/srep45636Aponte-Rueda ME, Saade Cárdenas RA, Saade Aure MJ. Endoscopic axillary dissection: a systematic review of the literature. Breast. 2009;18(3):150–158. PMID: 19493679. https://doi.org/10.1016/j.breast.2009.05.001Aponte-Rueda ME, Saade Cárdenas RA, Saade Aure MJ. Endoscopic axillary dissection: a systematic review of the literature. Breast. 2009;18(3):150–158. PMID: 19493679. https://doi.org/10.1016/j.breast.2009.05.001Malur S, Bechler J, Schneider A. Endoscopic axillary lymphadenectomy without prior liposuction in 100 patients with invasive breast cancer. Surg Laparosc Endosc Percutan Tech. 2001;11(1):38–42. PMID: 11269554.Malur S, Bechler J, Schneider A. Endoscopic axillary lymphadenectomy without prior liposuction in 100 patients with invasive breast cancer. Surg Laparosc Endosc Percutan Tech. 2001;11(1):38–42. PMID: 11269554.Isik A, Soran A, Grasi A, Barry N, Sezgin E. Lymphedema after sentinel lymph node biopsy: who is at risk?. Lymphat Res Biol. 2022;20(2):160–163. PMID: 34191608. https://doi.org/10.1089/lrb.2020.0093Isik A, Soran A, Grasi A, Barry N, Sezgin E. Lymphedema after sentinel lymph node biopsy: who is at risk?. Lymphat Res Biol. 2022;20(2):160–163. PMID: 34191608. https://doi.org/10.1089/lrb.2020.0093Chin K, Wärnberg F, Kovacs A, Olofsson Bagge R. Impact of surgical care bundle on surgical site infection after non-reconstructive breast cancer surgery: a single-centre retrospective comparative cohort study. Cancers (Basel). 2023;15(3):919. PMID: 36765876. PMCID: PMC9913200. https://doi.org/10.3390/cancers15030919Chin K, Wärnberg F, Kovacs A, Olofsson Bagge R. Impact of surgical care bundle on surgical site infection after non-reconstructive breast cancer surgery: a single-centre retrospective comparative cohort study. Cancers (Basel). 2023;15(3):919. PMID: 36765876. PMCID: PMC9913200. https://doi.org/10.3390/cancers15030919Langer I, Kocher T, Guller U, et al. Long-term outcomes of breast cancer patients after endoscopic axillary lymph node dissection: a prospective analysis of 52 patients. Breast Cancer Res Treat. 2005;90(1):85–91. PMID: 15770531. https://doi.org/10.1007/s10549-004-3268-6Langer I, Kocher T, Guller U, et al. Long-term outcomes of breast cancer patients after endoscopic axillary lymph node dissection: a prospective analysis of 52 patients. Breast Cancer Res Treat. 2005;90(1):85–91. PMID: 15770531. https://doi.org/10.1007/s10549-004-3268-6Kozak D, Głowacka-Mrotek I, Nowikiewicz T, et al. Analysis of undesirable sequelae of sentinel node surgery in breast cancer patients - a prospective cohort study. Pathol Oncol Res. 2018;24(4):891–897. PMID: 28918579. PMCID: PMC6132823. https://doi.org/10.1007/s12253-017-0306-3Kozak D, Głowacka-Mrotek I, Nowikiewicz T, et al. Analysis of undesirable sequelae of sentinel node surgery in breast cancer patients - a prospective cohort study. Pathol Oncol Res. 2018;24(4):891–897. PMID: 28918579. PMCID: PMC6132823. https://doi.org/10.1007/s12253-017-0306-3

The authors declare that there are no conflicts of interest present.