Non-sentinel lymph node metastasis in breast invasive ductal carcinoma patients with 1-2 positive sentinel lymph nodes

doi:10.3877/cma.j.issn.1674-0807.2017.03.005

Abstract

Abstract:

Objective

To analyze the metastasis of non-sentinel lymph node (NSLN) in breast invasive ductal carcinoma patients with 1-2 positive sentinel lymph nodes(SLNs).

Methods

A total of 220 patients with breast invasive ductal carcinoma in the Department of Breast Surgery, Southwest Hospital,Third Military Medical University from January 2010 to October 2015 were enrolled in this prospective study.All patients underwent sentinel lymph node biospy (SLNB), which confirmed the metastases of 1 to 2 SLNs,and then they underwent radical mastectomy. NSLN metastases were pathologically analyzed after operation.The relationship between NSLN metastases and molecular subtypes, staging of primary lesions, neoadjuvant chemotherapy, ER, PR, HER-2 and Ki67 expression was analyzed by χ² test. The relationship between NSLN metastases and patients' age was analyzed by nonparametric test.

Results

Totally 91 cases (91.4%,91/220)had positive NSLN, of which 90 cases had axillary lymph node metastasis in level Ⅰ, and only 1 case had axillary lymph node metastasis in both level Ⅰand Ⅱ. A total of 129 cases were NSLN negative,accounting for 58.6% (129/220). The molecular subtypes, staging of primary lesions, neoadjuvant chemotherapy, ER, PR and Ki67 expression and patient's age showed no significant effect on NSLN metastasis (χ² =1.830,1.336,0.918,0.074,0.000, 1.766, Z=-1.369; P=0.608,0.248,0.338,0.786,0.986,0.184,0.171). In 57 HER-2 positive patients, 30 were NSLN positive, with the positive rate of 52.6%. In 163 HER-2 negative patients,61 were NSLN positive, with the positive rate of 37.4%. The positive rate of NSLN in HER-2 positive patients was significantly higher than that in HER-2 negative patients (χ² =4.027, P=0.045).

Conclusion

The breast invasive ductal carcinoma patients with 1 to 2 positive SLNs are in high risk of NSLN metastasis, especially in patients with HER-2 positive.

Key words: Breast neoplasms, Carcinoma, ductal, breast, Sentinel lymph node biopsy, Mastectomy, modified radical

Hongbiao Mo, Yi Zhang, Jun Jiang. Non-sentinel lymph node metastasis in breast invasive ductal carcinoma patients with 1-2 positive sentinel lymph nodes[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(03): 148-151.

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References 22

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