To Analyse The Axillary Lymph Metastases Of The Breast Carcinoma And To Investigate The Sentinel Lymph Node Biopsy

Objective 1. To investigate the axillary lymph metastases of the breast carcinoma and the value of Ultrasound and physical in diagnosing the breast carcinoma metastasis in the axillary lymph node.2. To investigate the value of sentinel lymph node biopsy in the early breast cancer.Methods 1. The axillary lymph metastases of 531 cases with breast carcinoma was analysed. The state of axilla lymph node of 455 cases with breast carcinomas was checked by Physical and Pathology. The state of axilla lymph node of 139 cases with breast carcinomas was checked by Ultrasound and Pathology Then the analysis was made by Stata soft.2. SLNB was operated in 161 cases with early breast cancer.Results 1. There is 49.53 percent of 531 cases with axillarylymph metastases and 50.47 percent of cases without axillary lymph metastases.The biggest length of the breast carcinomas of 238 cases with axillary lymph metastases measured by Pathology was 4.05+ 2.28cm and that of 215 cases without axillary lymph metastases was 3.13 \2.28cm There is significantly difference, (p=0.0000) . The middle length of the breast carcinomas of 238 cases with axillary lymph metastases (3.07\1.64cm) is significantly bigger than that of 214 cases without axillary lymph metastases ( 3.32 \ 1.85cm ), (p=0.0001) . The smallest length of the breast carcinomas of 232 cases with axillary lymph metastases (2.09\0.94cm) is significantly bigger than that of 210 cases without axillary lymph metastases (1.68 \0.84cm), (p=0.0000) . The rate of the biggest length of tumor to breast is 0.32+0.23 (231 cases with axillary lymph metastases) and 0.25+0.22 (207 cases without axillary lymph metastases) There is significantly difference between two groups (p=0.0021) The age of 260 cases with axillary lymph metastases ( 52.77 \ 10.56y ) is significantly younger than that of 264 cases without axillary lymph metastases (54.72\11.49y), (p=0.0433) . The course of 246 cases with axillary lymph metastases (452.57\73.22 days) is significantly more than that of 253 cases without axillary lymph metastases (278.40 +44.98 days), (p=0.0420). The Physical's Se, Sp, alpha ,beta, accuracy, +PV and -PV separately is 49.79%, 81.39%, 18.61%, 50.21 %,65.38%,73.29%,61.24%.The Ultrasound's Se,Sp, alpha , beta,accuracy . +PV and -PV separately is 69.23%. 65.57%. 34.43%. 30.71%. 67.63%, 72.0%, 62.5%.2, The SLNB'sSe. Sp. alpha, beta, accuracy. +PV and-PV separately is96.1%. 100%. 0%, 3.9%, 98.6%, 100%, 97.8%.Conclusion 1, About half of cases without axillary lymph metastases do not need axillary dissection. There is relation between axillary lymph metastases and age, course, the size of tumor, the rate of the size of tumor to breast and the kind of pathology. The Physical's and Ultrasound's accuracy in diagnosing the breast carcinoma metastasis in the axilla lymph node are 65.38%, 67.63%. 2, The SLNB is a new technique of treament for breast cancers.lt is easy to be mastered after practicing.It's accuracy is 98.6%.ALND will be replaced by SLNB for those without axillary lymph metastases in the future.