Correlation of clinical factors between non-sentinel lymph nodes and 1, 2 positive patients with sentinel lymph node in breast cancer / 中国综合临床

ABSTRACT

Objective To analyze the relationship between non-sentinel lymph node ( NSLN ) metastases and clinicopathologic features in breast invasive ductal carcinoma patients with 1, 2 positive sentinel lymph node(SLN). Methods A total of one hundred and ninety-eight patients with breast invasive ductal carcinoma from January 2013 to December 2017 were enrolled in this prospective study. Modified radical mastectomy was performed after SLN1-2 positive cases were confirmed by biopsy. Postoperative NSLN was counted and the relationship between NSLN and clinical factors was analyzed. Results The positive rate of NSLN in 198 patients was 40. 9%(81/198),of which 80 cases were positive at axillary level I and only 1 case was positive at axillary level I and II. There was no significant correlation between NSLN positive and age (χ2＝1. 258),lesion grade (χ2＝1. 327),molecular typing (χ2＝1. 020),neoadjuvant chemotherapy (χ2＝0. 923),estrogen receptor (χ2＝0. 189),progesterone receptor ( χ2＝0. 109),Ki67 ( χ2＝1. 755) ( P＞0. 05). The positive rate of NSLN in HER-2 positive patients was 56. 9%(29/51),which was significantly higher than 35.4%(52/147) in HER-2 negative patients (χ2 ＝6.136,P＝0.034).Logistic regression analysis showed that HER-2 positive was an independent risk factor for NSLN ( OR＝0. 031,95%CI 0. 012－0. 615,P＝0. 022) . Conclusion The risk of NSLN positive in breast cancer patients such as SLN1-2 positive patients is still high,and the risk of NSLN positive in HER-2 positive patients is higher.