Influences of Sentinel Lymph Node Biopsy Following Total Mastectomy on Immunologic Function and Prognosis for Patients with Early Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XUXu-dong ¹ , LUJian-qin ² , SHENHan-bin ¹ , LUOZhi-yong ³ , XIAYun ³ , ZHANGLin ³ ,  WUYa-qun ³

1. Department of Thyroid and Breast Surgery, The Fifth Hospital of Wuhan City, Wuhan 430050, Hubei Province, China;
2. Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China;
3. Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China;

Corresponding author：

WUYa-qun, Email: wyqmd@126.com

Keywords：

Early breast cancer; Sentinel lymph node biopsy; Immunologic function; Prognosis

DOI：

10.7507/1007-9424.20150159

Video：

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Objective To evaluate the effects of sentinel lymph node biopsy following total mastectomy on immunologic function and prognosis for patients with early breast cancer. Methods Two hundred and eleven patients with early breast cancer were entered in this study. In all these cases, the results of sentinel lymph node biopsy were negative. These patients were randomly divided into control group and research group. In 86 cases of control group, the sentinel lymph node biopsy and axillary lymph node dissection following total mastectomy was performed. In 125 cases of research group, the sentinel lymph node biopsy following total mastectomy was performed. The injury of shoulder joint function was analyzed in one year after surgery. The changes of T cell subsets and IL-2 level were detected in the patients respectively on the first day before operation, the second week after operation, and the fourth week after operation. Postoperative fatality rate and postoperative recurrence rate were also observed in two groups. Results ①The points of shoulder joint function in the control group and the research group were 72.7±6.5 and 93.5±8.2 respectively, there was an obvious difference (P < 0.05).②The injury degree of shoulder joint function in the research group was significantly lower than that in the control group (P < 0.01).③Compared with the control group, the changes of T cell subsets and the IL-2 level had no significant differences in the research group on day 1 before operation and on week 2 after operation (P > 0.05). On the fourth week after surgery, the CD₄⁺, CD₄⁺/CD₈⁺, and IL-2 level in the research group were obviously higher than those in the control group (P < 0.05). However, the percentage of CD₈⁺ T cell in the research group was significantly lower than that in the control group (P < 0.05).④There were no significant differences for postoperative fatality rate and postoperative recurrence rate between two groups (P > 0.05). Conclusions Sentinel lymph node biopsy for patients with early breast cancer is safe and reliable. With respect to conventional axillary lymph node dissection, it could improve immune function and quality of life after surgery in patients with early breast cancer.

Citation： XUXu-dong, LUJian-qin, SHENHan-bin, LUOZhi-yong, XIAYun, ZHANGLin, WUYa-qun. Influences of Sentinel Lymph Node Biopsy Following Total Mastectomy on Immunologic Function and Prognosis for Patients with Early Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(5): 610-614. doi: 10.7507/1007-9424.20150159 Copy

1.	Miura D, Yoneyama K, Furuhata Y, et al. Paclitaxel enhances antibody-dependent cell-mediated cytotoxicity of trastuzumab by rapid recruitment of natural killer cells in HER2-positive breast cancer. J Nippon Med Sch, 2014, 81(4):211-220.
2.	Roslen NA, Alewi NA, Ahamada H, et al. Cytotoxicity screening of melastoma malabathricum extracts on human breast cancer cell lines in vitro. Asian Pac J Trop Biomed, 2014, 4(7):545-548.
3.	Sharma P, Stecklein SR, Kimler BF, et al. The prognostic value of BRCA1 promoter methylation in early stage triple negative breast cancer. J Cancer Ther Res, 2014, 3(2):1-11.
4.	Kim JH, Aulck L, Thamsuwan O, et al. The effect of key size of touch screen virtual keyboards on productivity, usability, and typing biomechanics. Hum Factors, 2014, 56(7):1235-1248.
5.	Stickeler E, Fehm T. Targeted and osteo-oncologic treatment in early breast cancer:what is state-of-the-art and what might become so within the next 5 years? Breast Care, 2014, 9(3):161-167.
6.	Maass N, Schem C, Bauerschlag DO, et al. Final safety and efficacy analysis of a phaseⅠ/Ⅱtrial with imatinib and vinorelbine for patients with metastatic breast cancer. Oncology, 2014, 87(5):300-310.
7.	Warren LE, Punglia RS, Wong JS, et al. Management of the regional lymph nodes following breast-conservation therapy for early-stage breast cancer:an evolving paradigm. Int J Radiat Oncol Biol Phys, 2014, 90(4):772-777.
8.	Renganathan L, Ramasubramaniam S, Al-Touby S, et al. What do Omani women know about breast cancer symptoms? Oman Med J, 2014, 29(6):408-413.
9.	Smith RA, Manassaram-Baptiste D, Brooks D, et al. Cancer screening in the United States, 2015:A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin, 2015, 65(1):30-54.
10.	张毅, 杨新华, 范林军, 等.腔镜下乳腺癌前哨淋巴结活检临床应用及效果分析.中国普外基础与临床杂志, 2012, 19(9):930-933.
11.	田春祥, 陈洁, 魏兵, 等.核素染料联合法在早期乳腺癌前哨淋巴结活检手术中的临床应用.中国普外基础与临床杂志, 2012, 19(9):934-938.
12.	Black DM, Jiang J, Kuerer HM, et al. Racial disparities in adoption of axillary sentinel lymph node biopsy and lymphedema risk in women with breast cancer. JAMA Surg, 2014, 149(8):788-796.
13.	Ibrahim NB, Anandan S, Hartman AL, et al. Radiographic findings after treatment with balloon brachytherapy accelerated partial breast irradiation. Radiographics, 2015, 35(1):6-13.
14.	Cibula D, Oonk MH, Abu-Rustum NR. Sentinel lymph node biopsy in the management of gynecologic cancer. Curr Opin Obstet Gynecol, 2015, 27(1):66-72.
15.	Jo MJ, Park JY, Song JS, et al. Biopathologic features and clinical significance of micrometatasis in the lymph node of early gastric cancer. World J Gastroenterol, 2015, 21(2):667-674.
16.	García Vicente AM, Soriano Castrejón Á, León Martín A, et al. Early and delayed prediction of axillary lymph node neoadjuvant response by (18)F-FDG PET/CT in patients with locally advanced breast cancer. Eur J Nucl Med Mol Imaging, 2014, 41(7):1309-1318.
17.	Donizy P, Kaczorowski M, Halon A, et al. Paucity of tumorinfiltrating lymphocytes is an unfavorable prognosticator and predicts lymph node metastases in cutaneous melanoma patients. Anticancer Res, 2015, 35(1):351-358.
18.	Giuliano AE, Gangi A. Sentinel node biopsy and improved patient care. Breast J, 2015, 21(1):27-31.
19.	Fattahi AS, Tavassoli A, Rohbakhshfar O, et al. Can methylene blue dye be used as an alternative to patent blue dye to find the sentinel lymph node in breast cancer surgery. J Res Med Sci, 2014, 19(10):918-922.
20.	Chong C, Walters D, De Silva P, et al. Subsequent axillary surgery after sentinel lymph node biopsy:Results from the BreastSurgANZ Quality Audit 2006-2010. Breast, 2013, 22(6):1215-1219.
21.	Manijeh M, Mehrnaz K, Violaine M, et al. In silico design of discontinuous peptides representative of B and T-cell epitopes from HER2-ECD as potential novel cancer peptide vaccines. Asian Pac J Cancer Prev, 2013, 14(10):5973-5981.
22.	Mukhopadhyay A, Dyring C, Stott DI. Comparison of prophylactic and therapeutic immunisation with an ErbB-2 (HER2) fusion protein and immunoglobulinⅤ-gene repertoire analysis in a transgenic mouse model of spontaneous breast cancer. Vaccine, 2014, 32(8):1012-1018.
23.	de Kruijf EM, Engels CC, van de Water W, et al. Tumor immune subtypes distinguish tumor subclasses with clinical implications in breast cancer patients. Breast Cancer Res Treat, 2013, 142(2):355-364.
24.	Miettinen M, McCue PA, Sarlomo-Rikala MA, et al. GATA3:A multispecific but potentially useful marker in surgical pathology a systematic analysis of 2 500 epithelial and nonepithelial tumors. Am J Surg Pathol, 2014, 38(1):13-22.
25.	Hachey KJ, Colson YL. Current innovations in sentinel lymph node mapping for the staging and treatment of resectable lung cancer. Semin Thorac Cardiovasc Surg, 2014, 26(3):201-209.

1. Miura D, Yoneyama K, Furuhata Y, et al. Paclitaxel enhances antibody-dependent cell-mediated cytotoxicity of trastuzumab by rapid recruitment of natural killer cells in HER2-positive breast cancer. J Nippon Med Sch, 2014, 81(4):211-220.
2. Roslen NA, Alewi NA, Ahamada H, et al. Cytotoxicity screening of melastoma malabathricum extracts on human breast cancer cell lines in vitro. Asian Pac J Trop Biomed, 2014, 4(7):545-548.
3. Sharma P, Stecklein SR, Kimler BF, et al. The prognostic value of BRCA1 promoter methylation in early stage triple negative breast cancer. J Cancer Ther Res, 2014, 3(2):1-11.
4. Kim JH, Aulck L, Thamsuwan O, et al. The effect of key size of touch screen virtual keyboards on productivity, usability, and typing biomechanics. Hum Factors, 2014, 56(7):1235-1248.
5. Stickeler E, Fehm T. Targeted and osteo-oncologic treatment in early breast cancer:what is state-of-the-art and what might become so within the next 5 years? Breast Care, 2014, 9(3):161-167.
6. Maass N, Schem C, Bauerschlag DO, et al. Final safety and efficacy analysis of a phaseⅠ/Ⅱtrial with imatinib and vinorelbine for patients with metastatic breast cancer. Oncology, 2014, 87(5):300-310.
7. Warren LE, Punglia RS, Wong JS, et al. Management of the regional lymph nodes following breast-conservation therapy for early-stage breast cancer:an evolving paradigm. Int J Radiat Oncol Biol Phys, 2014, 90(4):772-777.
8. Renganathan L, Ramasubramaniam S, Al-Touby S, et al. What do Omani women know about breast cancer symptoms? Oman Med J, 2014, 29(6):408-413.
9. Smith RA, Manassaram-Baptiste D, Brooks D, et al. Cancer screening in the United States, 2015:A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin, 2015, 65(1):30-54.
10. 张毅, 杨新华, 范林军, 等.腔镜下乳腺癌前哨淋巴结活检临床应用及效果分析.中国普外基础与临床杂志, 2012, 19(9):930-933.
11. 田春祥, 陈洁, 魏兵, 等.核素染料联合法在早期乳腺癌前哨淋巴结活检手术中的临床应用.中国普外基础与临床杂志, 2012, 19(9):934-938.
12. Black DM, Jiang J, Kuerer HM, et al. Racial disparities in adoption of axillary sentinel lymph node biopsy and lymphedema risk in women with breast cancer. JAMA Surg, 2014, 149(8):788-796.
13. Ibrahim NB, Anandan S, Hartman AL, et al. Radiographic findings after treatment with balloon brachytherapy accelerated partial breast irradiation. Radiographics, 2015, 35(1):6-13.
14. Cibula D, Oonk MH, Abu-Rustum NR. Sentinel lymph node biopsy in the management of gynecologic cancer. Curr Opin Obstet Gynecol, 2015, 27(1):66-72.
15. Jo MJ, Park JY, Song JS, et al. Biopathologic features and clinical significance of micrometatasis in the lymph node of early gastric cancer. World J Gastroenterol, 2015, 21(2):667-674.
16. García Vicente AM, Soriano Castrejón Á, León Martín A, et al. Early and delayed prediction of axillary lymph node neoadjuvant response by (18)F-FDG PET/CT in patients with locally advanced breast cancer. Eur J Nucl Med Mol Imaging, 2014, 41(7):1309-1318.
17. Donizy P, Kaczorowski M, Halon A, et al. Paucity of tumorinfiltrating lymphocytes is an unfavorable prognosticator and predicts lymph node metastases in cutaneous melanoma patients. Anticancer Res, 2015, 35(1):351-358.
18. Giuliano AE, Gangi A. Sentinel node biopsy and improved patient care. Breast J, 2015, 21(1):27-31.
19. Fattahi AS, Tavassoli A, Rohbakhshfar O, et al. Can methylene blue dye be used as an alternative to patent blue dye to find the sentinel lymph node in breast cancer surgery. J Res Med Sci, 2014, 19(10):918-922.
20. Chong C, Walters D, De Silva P, et al. Subsequent axillary surgery after sentinel lymph node biopsy:Results from the BreastSurgANZ Quality Audit 2006-2010. Breast, 2013, 22(6):1215-1219.
21. Manijeh M, Mehrnaz K, Violaine M, et al. In silico design of discontinuous peptides representative of B and T-cell epitopes from HER2-ECD as potential novel cancer peptide vaccines. Asian Pac J Cancer Prev, 2013, 14(10):5973-5981.
22. Mukhopadhyay A, Dyring C, Stott DI. Comparison of prophylactic and therapeutic immunisation with an ErbB-2 (HER2) fusion protein and immunoglobulinⅤ-gene repertoire analysis in a transgenic mouse model of spontaneous breast cancer. Vaccine, 2014, 32(8):1012-1018.
23. de Kruijf EM, Engels CC, van de Water W, et al. Tumor immune subtypes distinguish tumor subclasses with clinical implications in breast cancer patients. Breast Cancer Res Treat, 2013, 142(2):355-364.
24. Miettinen M, McCue PA, Sarlomo-Rikala MA, et al. GATA3:A multispecific but potentially useful marker in surgical pathology a systematic analysis of 2 500 epithelial and nonepithelial tumors. Am J Surg Pathol, 2014, 38(1):13-22.
25. Hachey KJ, Colson YL. Current innovations in sentinel lymph node mapping for the staging and treatment of resectable lung cancer. Semin Thorac Cardiovasc Surg, 2014, 26(3):201-209.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Influences of Sentinel Lymph Node Biopsy Following Total Mastectomy on Immunologic Function and Prognosis for Patients with Early Breast Cancer

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