Analysis Of Postoperative Prognosis In Patients With Sentinel Lymph Node Negative Breast Cancer After Axillary Preservation Surgery

Objective To observe the prognosis of breast cancer patients with negative sentinel lymph node biopsy after axillary preservation,and to analyze the related factors affecting the prognosis of adverse events.Methods The patients with early breast cancer who were diagnosed and treated in the first affiliated Hospital of Medical College of Shihezi University from January 1,2015 to December 31,2017 were collected retrospectively through the electronic medical record query system.Methylene blue combined with indocyanine green sentinel lymph node biopsy was performed during the operation,and intraoperative freezing showed that the sentinel lymph nodes were negative,so axillary lymph node dissection was not performed.The clinical data of patients with stage ? and stage ?invasive breast cancer were confirmed by postoperative paraffin examination.The postoperative local and regional recurrence,distant metastasis and death were followed up,and the effects of pathological features and postoperative treatment on the survival of the patients were analyzed.The local regional recurrence rate,distant metastasis rate,progression-free survival rate and overall survival rate were calculated by Kaplan-Meier method.Logrank method and COX proportional hazard model ware used for univariate analysis and multivariate regression analysis.Results A total of 184 patients were screened,1 case lost follow-up,the rate of lost follow-up was 0.54%(1/184).Combined with the postoperative paraffin results,a total of 1135 sentinel lymph nodes were removed,with an average of 6 ± 3.The patients were followed up for 27 months,with a median follow-up time of 46 months,with a follow-up rate of 99.13%.One patient had local chest wall recurrence 41 months after operation,and the local recurrence rate was 0.55%(1/183);1 case had ipsilateral axillary lymph node recurrence 14 months after operation,and the regional recurrence rate was 0.55%(1/183);1 case had bone,lung and pleural metastasis 41 months after operation,and the distant metastasis rate was 0.55%(1/183).Two patients died of other non-causes of the disease,with an overall survival rate of98.91%(181/183),a progression-free survival rate of 98.36%(180/183),and an end-point event rate of 1.64%(3/183).According to the results of the return visit,the survival curve was drawn,and univariate analysis showed that vascular infiltration was a risk factor for end-point events,and the difference was statistically significant(HR=87.82,95% CI 11.23-112.22,P<0.01).Multivariate regression showed that vascular invasion was the only independent risk factor,and the difference was statistically significant(HR=57.76,95% CI 8.88-181.67,P<0.01).Conclusion1.Sentinel lymph node biopsy is safe and reliable and is suitable for patients with early breast cancer and negative axillary lymph nodes.2.With vascular invasion,it may increase the risk of tumor progression in patients with sentinel node negative breast cancer after axillary preservation surgery,which is an independent risk factor for postoperative disease progression of breast cancer.