Risk Factor Analysis For Axillary Lymph Nodes Metastasis In Breast Cancer Patients With Sentinel Lymph Nodes Metastasis

Objective: This study analyzed retrospectively 164 cases of sentinel lymph node biopsy(SLNB)positive,axillary lymph node cleaning the clinical pathologic data of breast cancer patients,explore SLNB positive axillary lymph node metastasis in patients with breast cancer risk factors,in order to further explore what conditions of SLNB can avoid the axillary lymph node positive breast cancer patients cleaning the foundation,so that part of the breast cancer patients on the premise of ensuring effective treatment,narrowing the scope of operation,improve the quality of life.Methods: The clinicopathological data of 164 breast cancer patients with slnb-positive and axillary lymph node dissection admitted to the breast center of the fourth hospital of hebei medical university from May 2017 to January 2019 were reviewed.1.Patients meet the criteria:1)The pathology of paraffin was invasive lobular carcinoma,invasive ductal carcinoma or invasive mixed carcinoma;2)Breast cancer patients with at least one intraoperative SLNB frozen pathological metastasis who underwent axillary lymph node dissection and paraffin pathology confirmed sentinel lymph node metastasis;3)Preoperative chemotherapy was not performed;4)No obvious enlargement of axillary lymph nodes was found on clinical examination and auxiliary examination;5)The clinicopathological data were relatively complete.2.Exclusion criteria are:1)Patients with other malignant tumors;2)Patients with breast cancer accompanied by distant metastasis patients who had received anti-tumor treatment before surgery;3)Patients with bilateral breast cancer and polycentricity special types of breast cancer(adenocarcinoma,medullary cancer,etc.);4)Incomplete clinicopathological data.According to the situation of non-sentinel lymph node metastasis,the patients were divided into non-sentinel lymph node positive group and non-sentinel lymph node negative group,and relevant clinicopathological data were collected to analyze the correlation between them and non-sentinel lymph node metastasis in slnb-positive breast cancer patients.SPSS 21.0 software was used for statistical processing of data,and chi-square test was used for comparison of sample rates.Logistic regression model was used for multivariate analysis.Bilateral test was used,and the test level was P=0.05.Results:1)The single factor analysis results were as follows: the number of sentinel lymph node positive(P < 0.001),sentinel lymph node metastasis rate(P=0.046),tumor location(P = 0.016)in the sentinel lymph node distribution between the positive and the sentinel lymph node negative groups statistically significant difference,while age,vascular recidivism,histological grade,tumor size,ER,PR,its ehrs-2,Ki-67 distribution between the two groups have no statistical differences.2)The results of multivariate analysis showed that the number of positive sentinel lymph nodes(P<0.001)was an independent risk factor for non-sentinel lymph node metastasis in the axilla.Conclusion: The number of positive sentinel lymph nodes?sentinel node metastasis rate and the location of the mass are related to the axillary non-sentinel lymph node metastasis.The number of sentinel lymph node positive was an independent risk factor for axillary non-sentinel lymph node metastasis.For breast cancer with 1 or 2 sentinel node metastases,it is possible to avoid further axillary lymph node dissection.