Analysis Of Predictive Factors For Non-sentinel Lymph Node Of Breast Cancer Patients With Positive SLNs

Objective:To analyze the characteristics of patients who underwent sentinel lymph nodes biopsy(SLNB)and axillary lymph node dissection(ALND)and investigate the feasibility of avoiding axillary lymph node dissection for the patients with positive SLNs.To analyze the predictive factors for non-sentinel lymph node metastasis of patients with positive SLNs.Methods:This dissertation reported a retrospective study of 62 patients with invasive breast carcinomas who underwent sentinel lymph nodes biopsy and axillary lymph node dissection in the Affiliated Dayi Hospital of ShanXi Medical University from March2013 to October 2017.Inclusion criteria:1)Pathological type is invasive lobular carcinoma,invasive ductal carcinoma or invasive mixed tumor;2)The number of non-axillary sentinel lymph nodes were no less than 10;3)There was no preoperative anti-cancer therapy;4)Clinical and imaging examinations(ultrasonography,mammography and/or MRI and other imaging examination)showed negative axillary or needle biopsy assessments of suspicious lymph nodes were negative.Exclusion criteria:1)Pathological type is special invasive breast cancer(mucinous carcinoma,medullary carcinoma,adenocarcinoma,etc.);2)The number of non-sentinel lymph nodes was less than 10.According to the status of non-sentinel lymph nodes(NSLN)metastasis divided patients into NSLNB(+)and NSLNB(-)two groups and make comparative analysis of the relevant parameter between them.SPSS 19.0 software was applied.Chi-squareor test was used to compare the sample rate.Multivariate analysis was performed with the logistic regression model.All data were two-sided test,P=0.05.Results:Age,the number of positive SLNs and tumor size were correlated with NSLN metastasis.P value was 0.007 ?0.017? 0.008 respectively.Tumor size was positively correlated with NSLN,age and the number of negative SLN were negatively correlated with NSLN.There was no statistical significance between menopausal,tumor location,the number of negative SLNs,positive sentinel lymph node transfer ratio,nuclear grade,lymphatic invasion status,nerve invasion status,tumor estrogen receptor status,tumor progesterone receptor status,HER-2,Ki-67,pathological type and NSLN metastasis.Tumor size was an independent predictive factor for NSLN metastasis,P value was0.027.Not accept axillary lymph node dissection may be safe for these patients whose tumor was less than 2cm.Conclusion:Age,the number of positive SLN and tumor size were correlated with NSLN metastasis.Tumor size was an independent predictive factor for NSLN metastasis.Do not accept axillary lymph node dissection may be safe for these patients whose tumorwas less than 2cm.