Analysis Of Risk Factors For Sentinel Lymph Node Metastasis In Early Breast Cancer

Objective:To analyze the clinical-pathologic characteristics in patients with early breast cancer,and to investigate the risk factors of sentinel lymph node and non- sentinel lymph node metastases.Methods :This cohort included 148 patients with early breast cancer(T1-2N0M0) who underwent sentinel lymph node biopsy(SLNB) in Shanxi Dayi Hospital between March2012 to December 2014.We analyzed the correlative clinical-pathologic variables of patients with sentinel lymph node metastases, and the independent risk factors related to non-sentinel lymph node metastases in patients with positive SLNs. Chi-square test and Logistic multivariate regression analysis were carried out in this study. A probability level of <0.05 was considered statistically significant.Results:One-hundred and forty-eight of 153 patients were successfully underwent SLNB.Eighty-two patients had equal to or less than 2 SLNs,and 66 patients had more than 2SLNs. The mean number of SLNs was 2.6. The median numbers was 2. Fifty-seven of385 SLNs were positive. The detection rate was 96.7%(148/153). There were 103 patients(69.6%) with negative SLNs. There were 45 patients(30.4%) with positive SLNs. All patients with positive SLNs received axillary lymph node dissection(ALND), then 23 patients were positive SLNs 51.1%(23/45) and 22 patients were positive NSLN48.9%(22/45). Univariate analysis showed that the tumor size and vascular infiltration were associated with SLN metastases in the two groups of patients. The difference was statistically significant(P <0.05). Multivariate analysis indicated that vascular invasion was an independent risk factor for SLN metastases(OR = 4.27, 95% CI, 2.03~8.98). Age,body mass index(BMI), menopausal status, tumor location, the number of tumor foci,clinical stage, histological type, HER-2 status, Ki67, the number of SLN detected, ER / PR status, surgical approach and other variable factors had nothing to do with SLN metastases,without statistically significant difference(P> 0.05). Univariate analysis showed that the number of SLN related to the NSLN metastases in patients with positive SLNs.Multivariate analysis indicated the former was an independent risk factor for the latter(OR= 7.27, 95% CI, 1.35~39.05). While the number of tumor foci, primary tumor size(pathology), vascular invasion, the number of negative SLNs, were not statistically associated with NSLN metastases(P> 0.05).Conclusion:Vascular invasion is an independent risk factor for SLN metastases; the number of positive SLNs is an independent risk factor for NSLN metastases.