Study On The Correlation Between Ultrasonographic Characteristics、immunohistochemical Indexes And Axillary Lymph Node Metastasis In Invasive Breast Cancer

Objective:To explore the correlation between the ultrasonographic signs,clinicopathological factors,immunohistochemical indicators and axillary lymph node metastasis of invasive breast cancer,and to provide the basis for clinical evaluation of axillary lymph node status of invasive breast cancer.Methods:We retrospectively analyzed the breast ultrasound images,clinical data,histopathological findings and immunohistochemical indicators of 115 invasive breast cancer patients admitted to the Department of Breast Surgery,Nanhua Hospital,Affiliated to the University of South China between 2015 and 2020 who underwent breast cancer resection,axillary lymph node dissection and/or sentinel lymph node biopsy.According to the postoperative axillary lymph node metastasis,the patients were divided into metastatic group and non-metastatic group.The ultrasonographic signs of primary breast cancer,ultrasonographic diagnosis of axillary lymph node,clinical data,histopathological results and immunohistochemical indexes were compared between the two groups.SPSS 25.0 statistical software was used for data analysis,(?)±s was used as measurement data,X~2 test was used for comparison between groups,and P=0.05 was used as test standard.Univariate analysis and Logic binary regression analysis were used to find the influencing factors of axillary lymph node metastasis.Results:Among the 115 cases of invasive breast cancer,the mean age of the patients was 53.78±9.47 years old,the mean size of the breast mass was 27.49±11.4mm,and 60 cases(52.2%)had axillary lymph node metastasis.82 cases(71.3%)had tumor diameter ≥20mm,and 53 cases(46.1%)had metastasis.74 patients(64.3%)had high expression of Ki-67,and 44 patients(13.9%)had metastasis.Tumor blood flow grade 2-3 was found in 35 cases(30.4%),and metastasis occurred in 33 cases(28.7%).60 cases(52.2%)of axillary lymph nodes were suspected by ultrasound,and 40 cases(34.8%)of axillary lymph nodes were metastasis.The pathological classification of the tumor was invasive lobular carcinoma in 20 cases(17.4%)and metastases in 15 cases(13%).Univariate analysis found that Tumor size,blood flow grade,pathological classification,Ki-67 expression,axillary lymph node ultrasound diagnosis were correlated with lymph node metastasis(P<0.05),but tumor morphology,boundary,A/T,microcalcification,molecular classification,HER-2,ER,PR expression and patient age were not correlated with axillary lymph node metastasis(P>0.05).The results of multivariate analysis showed that the lymph node metastasis rate of patients with the largest tumor diameter ≥20mm was 9.776 times that of patients with the largest tumor diameter <20mm(P<0.05).The lymph node metastasis rate of patients with suspected axillary lymph node ultrasound was 35.803 times that of those with normal axillary lymph node ultrasound(P<0.05).The lymph node metastasis rate of PR positive patients was slightly higher than that of negative patients,with no significant difference(P>0.05)Conclusion:1.Tumor size,blood flow grade,histomathological classification,Ki-67 expression and ultrasonographic diagnosis of axillary lymph node metastasis were correlated with breast cancer.2.Maximum tumor diameter ≥20mm was an independent risk factor for axillary lymph node metastasis of breast cancer.