surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2025-15-2-53-63surgonco-1087Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSМетастазирование в регионарные лимфоузлы при раке молочной железы: современные представления о методах выявленияMetastases to Regional Lymph Nodes in Breast Cancer: Current Views of Detection Methodshttps://orcid.org/0000-0001-8827-8143КондрашкинИ. Е.KondrashkinI. E.

Кондрашкин Иван Евгеньевич — ординатор, кафедра хирургии и онкологии

Саратов 

Ivan E. Kondrashkin — Resident, Department of Surgery and Oncology

Saratov 

ivan.kondrashckin@yandex.ruhttps://orcid.org/0000-0002-4586-6591ФедоровВ. Э.FedorovV. E.

Федоров Владимир Эдуардович — д.м.н., профессор, кафедра хирургии и онкологии, хирургическое отделение

Саратов 

Vladimir E. Fedorov — Dr. Sci. (Med.), Prof., Department of Surgery and Oncology, Surgery Unit

Saratov 

https://orcid.org/0000-0002-6135-9223БарсуковВ. Ю.BarsukovV. Y.

Барсуков Владислав Юрьевич — д.м.н., профессор, кафедра хирургии и онкологии, онкологическое отделение с применением хирургических методов лечения

Саратов 

Vladislav Y. Barsukov — Dr. Sci. (Med.), Prof., Department of Surgery and Oncology, Oncology Unit with Surgical Treatment Methods

Saratov 

https://orcid.org/0009-0007-8210-5779ОрловаЮ. И.OrlovaY. I.

Орлова Юлия Ивановна — к.м.н., отделение радиологии

Саратов 

Yulia I. Orlova — Cand. Sci. (Med.), Department of Radiology

Saratov 

https://orcid.org/0000-0002-6286-4504ЖандароваЛ. Ф.ZhandarovaL. F.

Жандарова Людмила Федоровна — к.м.н., доцент, кафедра хирургии и онкологии, цитологическое отделение

Саратов 

Ludmila F. Zhandarova — Cand. Sci. (Med.), Assoc. Prof., Department of Surgery and Oncology, Cytology Unit

Saratov 

Саратовский государственный медицинский университет имени В.И. РазумовскогоРоссияSaratov State Medical University named after V.I. RazumovskyRussian FederationСаратовский государственный медицинский университет имени В.И. Разумовского ; Клиническая больница «РЖД-Медицина»РоссияSaratov State Medical University named after V.I. Razumovsky ; Clinical Hospital “RZD–Medicine”Russian FederationКлиническая больница «РЖД-Медицина»РоссияClinical Hospital “RZD–Medicine”Russian Federation202501072025152149159Copyright © Кондрашкин И.Е., Федоров В.Э., Барсуков В.Ю., Орлова Ю.И., Жандарова Л.Ф., 20252025Кондрашкин И.Е., Федоров В.Э., Барсуков В.Ю., Орлова Ю.И., Жандарова Л.Ф.Kondrashkin I.E., Fedorov V.E., Barsukov V.Y., Orlova Y.I., Zhandarova L.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/1087

В России рак молочной железы является наиболее распространенной онкологической патологией среди женского населения и составляет 22,5 % от общей массы онкологических заболеваний. Около 90 % смертей от данного заболевания связаны с метастазированием раковых клеток. В связи с этим эффективное выявление метастазов в регионарной лимфатической системе при развитии опухолей молочной железы — это ключевой элемент диагностики. За последние 10–20 лет современные технологии верификации метастатически измененных регионарных лимфатических узлов при раке молочной железы усовершенствовались и стали демонстрировать высокую эффективность. Определение сторожевого лимфатического узла стало возможным благодаря использованию различных красителей, радиоизотопов, суперпарамагнитных наночастиц. Выявление метастатически измененных образований проводится с помощью радиоизотопной лимфосцинтиграфии, однофотонной эмиссионной компьютерной томографии, совмещенной с компьютерной томографией и позитронно-эмиссионной томографии, совмещенной с компьютерной томографией. Полученные сведения позволили охарактеризовать преимущества и недостатки применяемых способов диагностики метастатически измененных регионарных лимфатических узлов. Радиоизотопная лимфосцинтиграфия отличается минимальной инвазивностью и высокой точностью, а также низким риском осложнений, но при этом является недостаточно безопасным и дорогостоящим методом. Использование суперпарамагнитных наночастиц не оказывает существенного негативного влияния на организм человека, является простым в использовании, однако данный способ недостаточно изучен и пока еще мало распространен. Однофотонная эмиссионная компьютерная томография, совмещенная с компьютерной томографией, обладая высокой чувствительностью, позволяет узнать точную локализацию сторожевого лимфатического узла, но его недостатком является наличие лучевой нагрузки на пациента и высокая стоимость проведения данной процедуры. Результаты анализа публикаций подтверждают значимость и эффективность современных технологий верификации метастатически измененных регионарных лимфатических узлов при раке молочной железы, что позволяет выбрать оптимальный метод диагностики, ведущий к снижению травматичности мастэктомии и лимфодиссекции, увеличить выживаемость, снизить вероятность возникновения рецидивов и прогресса онкологического процесса.

In Russia, breast cancer is the most prevalent oncological pathology among female patients, accounting for approximately 22.5% of all cancer cases. Approximately 90% of mortalities associated with this condition are attributed to the metastasis of cancer cells. Consequently, the effective detection of metastases within the regional lymphatic system during breast tumor progression is a critical diagnostic component. In recent decades, methodologies for verifying metastatic regional lymph nodes in breast cancer patients have advanced significantly, demonstrating high efficacy. The identification of sentinel lymph nodes became feasible through the use of various dyes, radioisotopes, and superparamagnetic nanoparticles. Detection techniques for metastatically affected formations include radioisotope lymphoscintigraphy, single-photon emission computed tomography (SPECT) often in combination with computed tomography (CT), and positron emission tomography (PET) typically integrated with CT. The accumulated data enabled an assessment of the advantages and limitations of current diagnostic methods. Radioisotope lymphoscintigraphy offers minimal invasiveness, high accuracy, and a low risk of complications; however, it remains insufficiently safe and cost-prohibitive. The application of superparamagnetic nanoparticles exerts negligible adverse effects on the human body and is characterized by straightforward administration. However, this method remains understudied, with its implementation being limited. Although the SPECT in combination with CT offers high sensitivity, thereby facilitating precise sentinel lymph node localization, it is associated with. exposure to ionizing radiation for the patient and the associated high procedural costs. Published data confirm the significance and efficacy of modern techniques for verifying metastatic regional lymph nodes in breast cancer. Therefore, the optimal diagnostic approaches can be selected, while reducing the invasiveness of mastectomy and lymph node dissection, improving survival rates, and decreasing the probability of recurrence or cancer progression.

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