腋窝淋巴结清扫与前哨淋巴结活检在乳腺癌诊疗中的应用价值及对术后上肢淋巴水肿的影响OA

Objective To investigate the application outcomes of axillary lymph node dissection(ALND)versus sentinel lymph node biopsy(SLNB)in breast cancer treatment and their impact on postoperative upper limb lymphedema.Methods A total of 120 patients with breast cancer treated between February 2021 and February 2023 were enrolled.According to random number table method,they were divided into ALND group(n=60)and SLNB group(n=60).The ALND group received ALND,while the SLNB group received SLNB.The clinical effect at 6 months and 1 year after surgery,positive rate of sentinel lymph nodes,upper limb lymphedema and dysfunction within 1 year after surgery,and improvement of upper limb function and quality of life before and at 1 year after surgery were compared between the two groups.Results At 6 months and 1 year after surgery,there was no significant difference in response rates of treatment between SLNB group[88.33%(53/60)and 85.00%(51/60)]and ALND group[91.67%(55/60)and 80.00%(48/60)](P>0.05).The positive rate of sentinel lymph nodes in SLNB group was lower than that in ALND group[3.33%(2/60)vs.16.67%(10/60),P<0.05].At 1 year after surgery,incidence of upper limb lymphedema in SLNB group was lower than that in ALND group(P<0.05).At 1 year after surgery,there was no significant difference in upper limb dysfunction between the two groups(P>0.05).At 1 year after surgery,scores of upper limb function index and quality of life in SLNB group were higher than those in ALND group(P<0.05,P<0.01).Conclusion SLNB has significant advantages in reducing postoperative lymphedema and improving postoperative quality of life.However,both ALND and SLNB achieve comparable short-term tumor control effects.