外科理论与实践

外科理论与实践 >

2026 , Vol. 31 >Issue 03: 191 - 195

DOI: https://doi.org/10.16139/j.1007-9610.2026.03.03

专家论坛

乳腺癌腋窝管理的降阶梯趋势：循证进展与未来方向

  • 商庆尧 ,
  • 董旭彬 ,
  • 岳家贤 ,
  • 王昕
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  • 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院， 北京 100210
作者贡献/Authors’ contributions

商庆尧负责资料的收集和撰写；董旭彬、岳家贤负责文献查阅；王昕负责指导、审查和修订。所有作者均阅读并确认最终稿。

王昕，E-mail: xinwang@vip.126.com

收稿日期: 2026-02-06

  网络出版日期: 2026-08-11

基金资助

北京市自然科学基金杰出青年科学基金项目(JQ23032);国家癌症中心攀登基金(NCC202416004);首都卫生发展科研专项(2024-2-4025)

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De-escalation trends in axillary management for breast cancer: evidence-based progress and future directions

  • SHANG Qingyao ,
  • DONG Xubin ,
  • YUE Jiaxian ,
  • WANG Xin
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  • National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College， Beijing 100210, China

Received date: 2026-02-06

  Online published: 2026-08-11

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摘要

乳腺癌腋窝管理正从传统的广泛清扫转向更注重风险分层与减少干预的精准降阶梯模式。在系统治疗和影像评估能力显著提升的背景下，减少乃至豁免部分腋窝手术与放疗已成为可行方向，可在不牺牲肿瘤学安全性前提下有效减少上肢并发症发生。未来需依托多模态评估与个体化预测模型进一步明确适用人群与决策依据，推动腋窝管理向更精准、创伤更小的路径发展。

关键词： 乳腺癌; 精准降阶梯; 前哨淋巴结活检; 腋窝淋巴结清扫

本文引用格式

商庆尧 , 董旭彬 , 岳家贤 , 王昕 . 乳腺癌腋窝管理的降阶梯趋势：循证进展与未来方向[J]. 外科理论与实践, 2026 , 31(03) : 191 -195 . DOI: 10.16139/j.1007-9610.2026.03.03

Abstract

Axillary management in breast cancer is shifting from traditional extensive dissection toward a precision de-escalation approach that emphasizes risk stratification and reduced intervention. With advances in systemic therapy and imaging assessment, minimizing or even omitting certain axillary surgeries and radiotherapy procedures has become a feasible strategy, effectively lowering upper-limb complications without compromising oncologic safety. Future efforts should integrate multi-modal evaluation and individualized predictive models to refine patient selection and clinical decision-making, and further guide the development of more precise and less invasive axillary management pathways.

Key words： Breast cancer; Precision de-escalation; Sentinel lymph node biopsy (SLNB); Axillary lymph node dissection(ALND)

参考文献

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