Analysis Of Axillary Lymph Node Status Of 1 To 2 Sentinel Lymph Node Biopsies Positive For Early Breast Cancer

Objective:To investigate whether axillary lymph node dissection should be exempted in patients with early breast cancer with 1 to 2 positive sentinel lymph node biopsies.Methods:In this study,the case data of 200 female breast cancer patients admitted to the outpatient or inpatient department of the glandular vascular surgery department of the Affiliated Hospital of Yan’an University from January 2018 to December 2020 were retrospectively analyzed,and SLNB and SLND were performed on all of them.All patients were informed of the surgical method preoperatively and signed informed consent.Preoperative 15 minutes with a single line of SLNB dye method,this research USES 1%1 ml methylene blue solution on one side of mammary areola around 3,6,9 and12 points,intradermal injection technique will be cleaning the aizen lymph node to send intraoperative rapid freezing,results suggest the sentinel lymph node metastasis,further lines of axillary lymph node cleaning,cleaning the postoperative armpit fat tissue after formalin soaked the pathological examination.The axillary lymph node status of patients with 1-2 positive sentinel lymph nodes in early breast cancer was analyzed,including age,BMI,menstrual status,tumor size,pathological molecular typing,ER,PR,HER-2,Ki-67and other indexes related to axillary lymph node status,to further guide whether axillary lymph node dissection could be avoided for such patients.The effects of age,BMI,menstrual status,molecular typing,grade of primary foci,ER,PR,HER-2,Ki-67 index and other indexes on ALN metastasis were analyzed.?~2 test or FISH accurate test was used,and P<0.05 was statistically significant.Results:In this study,a total of 200 patients with early breast cancer were enrolled,all of whom had 1-2 sentinel lymph node metastases,followed by axillary lymph node dissection.Of the 68 cases with axillary lymph node metastasis,all were axillary region I lymph node metastasis,accounting for 34%of the total(68/200).There were 132 cases without axillary lymph node metastasis,accounting for 66%of the total(132/200).Results in Table 1 showed that there was no statistical significance in the effects of age,BMI,tumor size,menstrual status,molecular typing,ER,PR,Ki-67 and other indicators on axillary lymph node metastasis(?~2=0.119,2.775,1.643,0.013,6.105,0.134,0.802,0.801;P=0.730,0.250,0.200,0.909,0.107,0.715,0.370,0.371).Among 71 patients with positive HER-2,metastatic patients accounted for 45%(32/71)and non-metastatic patients accounted for 55%(39/71).Of the 129 patients with negative HER-2,28%(36/129)had axillary metastasis,while 93(72%)had no metastasis.As can be seen from the results of this study,there was a statistically significant difference in the influence of HER-2 on axillary lymph node metastasis(?~2=6.012,P<0.05).Conclusion:For 1-2 patients with sentinel lymph nodes,ALND,can be exempted from replacing it with chemotherapy and radiotherapy,so as to reduce the occurrence of complications after axillary dissection in patients with early breast cancer.For Her-2-positive patients,further treatment is required.