Risk Factors Of Axillary Lymph Node Imaging False Negative After Neoadjuvant Therapy For Locally Advanced Breast Cancer

Objective:To analyze the recurrence and survival differences among true negative,false negative and true positive axillary lymph node imaging after neoadjuvant therapy for locally advanced breast cancer,and to explore the risk factors associated with false negative axillary lymph node imaging after neoadjuvant therapy for locally advanced breast cancer.Methods:Objective to analyze the clinical data of patients with locally advanced breast cancer treated with neoadjuvant therapy in Hospital from January 2016 to January 2020,and to follow up their survival.All patients underwent surgery after the end of neoadjuvant therapy cycle.According to their imaging and postoperative pathological diagnosis,they were divided into three groups: imaging true negative,false negative and true positive All the factors that may affect the results of imaging diagnosis were included in the logistic univariate and multivariate analysis,and the related risk factors of false negative imaging were obtained.Results:During the follow-up,12 cases(5.89%)of the true positive group had recurrence,3(4.92%)died,4 cases(12.90%)in the false negative group,1(3.22%) died,2(19.67%)in the true negative group and 0 died(Table 2).The average time of life without tumor was 31.5(month)vs 26(month)vs 21(month),and 32(month)vs26(month)vs 24(month)in median vs false negative group.There was statistical difference in DFS among the three groups,but no significant difference in OS. Logistic single factor analysis showed that the risk factors influencing false negative of axillary lymph node imaging after new adjuvant treatment of local advanced breast cancer were: age ≤ 45 years(p=0.011),longest diameter of lymph node ≥ 2cm(p=0.01),BMI ≥ 24kg/m2(p=0.04),ki-67≥30%(P=0.008).The independent risk factors of false negative of axillary lymph node imaging after neoadjuvant treatment of local advanced breast cancer were: the longest diameter of lymph node was ≥ 2cm,(HR = 4.921 95% CI: 1.04-23.36,P= 0.045),ER receptor expression was negative(HR = 11.25 95% ci:3.31-38.35,P =0.001)。Conclusion:There was significant difference in DFS among the three groups,the true positive group was higher than the false negative group and the true negative group,and the false negative group was significantly higher than the true negative group;there was no difference in OS among the three groups.The primary lesion was located in the upper quadrant,and the age was ≤ 45 years old,The longest diameter of lymph node ≥ 2cm,tumor diameter ≥ 2cm,BMI ≥ 24 kg / m2,negative ER receptor,Ki-67 ≥ 30% were the risk factors of false negative imaging after neoadjuvant therapy.The longest diameter of lymph node ≥ 2cm,negative ER receptor expression were the independent risk factors of false negative imaging after neoadjuvant therapy.