Обзор современных подходов видеоассистированной эндоскопической биопсии сигнальных лимфатических узлов и аксиллярной лимфодиссекции

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.

1. Gradishar 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.2023.0031

2. Keelan 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.2021.622621

3. Lin 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/znab279

4. Cao 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.2021.07.015

5. Bharath 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-w

6. Jiang 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.2022.818812

7. Chen 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.2020.11501

8. Sanders 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/s10434-022-12064-4

9. Elshanbary 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/s11356-022-20569-4

10. Barrio 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.2021.4394

11. Hartmann 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-1889-7883

12. Yao 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-w

13. Liang 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/10.1177/1553350620942983

14. Serra-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.0000000000001208

15. Wang 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/s00464-023-10018-9

16. Liu 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-y

17. Kim 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.0000000000000641

18. Du 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/srep45636

19. Aponte-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.2009.05.001

20. 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.

21. 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.2020.0093

22. Chin 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/cancers15030919

23. Langer 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/s10549-004-3268-6

24. Kozak 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