腋窝淋巴结清扫术是当前治疗炎性乳腺癌 (IBC) 腋窝的标准。本研究旨在确定通过夹子放置识别的最初阳性淋巴结能否准确代表 IBC 新辅助化疗（NAC）后腋窝的整体淋巴结状态。对接受手术的 IBC 患者（2014-2023）进行了回顾性研究。对于诊断时在阳性腋窝淋巴结中放置夹子的 IBC 患者，审查手术记录、X 线标本和病理报告，以确认夹闭淋巴结的最终病理状态。总共，确定了 92 名 IBC 患者 (90 cN)（中位年龄 54 岁，78% 侵入导管，10% 侵入小叶，12% 混合）； 81 (90%) 经活检证实为 cN，其中 62/81 (77%) 将夹子放置在阳性淋巴结中。所有患者均接受 NAC 和腋窝手术治疗，中位切除 19 个（范围 4-49）个淋巴结。在 28 名（共 56 名）取回病理学阴性 (ypN0) 淋巴结的患者中，只有 1 名患者有一个额外的微转移阳性淋巴结，假阴性率为 4% (95% CI 1-19%)。相反，3/3 仅在夹闭淋巴结中发现孤立肿瘤细胞 (ITC) 的患者有其他腋窝疾病（1 例中有 ITC，2 例有大转移），20/23 (87%) 的夹闭淋巴结病理呈阳性（微转移或大转移）。更大）有额外的阳性淋巴结 [19/20 (95%) 伴有大转移]。IBC 中夹取的活检阳性腋窝淋巴结准确地代表了 NAC 后整体腋窝淋巴结状态。 NAC 后的 ITC 应被视为阳性，作为有转移的其他淋巴结的指标。© 2024。作者。

Axillary lymph node dissection is the current standard for management of the axilla in inflammatory breast cancer (IBC). The present study aims to determine whether the initially positive node identified by clip placement accurately represents the overall nodal status of axilla after neoadjuvant chemotherapy (NAC) in IBC.A retrospective study was conducted on patients with IBC who underwent operation (2014-2023). For patients with IBC who had clip placement in a positive axillary node at diagnosis, operative notes, specimen radiographs, and pathology reports were reviewed to confirm final pathologic status of clipped nodes.In total, 92 patients with IBC (90 cN+) were identified (median age 54 years, 78% invasive ductal, 10% invasive lobular, and 12% mixed); 81 (90%) were biopsy-proven cN+, with a clip placed in the positive node for 62/81 (77%). All patients were treated with NAC and axillary surgery with median 19 (range 4-49) nodes removed. Among 28 (out of 56) patients with retrieved clipped nodes that were pathologically negative (ypN0), only 1 had an additional positive node with micrometastasis for a false negative rate of 4% (95% CI 1-19%). Conversely, 3/3 patients with isolated tumor cells (ITCs) only in the clipped node had additional axillary disease (ITCs in 1, macrometastasis in 2), and 20/23 (87%) of patients with pathologically positive clipped node (micrometastasis or greater) had additional positive nodes [19/20 (95%) with macrometastasis].The clipped biopsy-positive axillary node in IBC accurately represented the post-NAC overall axillary nodal status. ITCs post-NAC should be considered positive as an indicator of additional nodes with metastasis.© 2024. The Author(s).