The Analysis Of Risk Factors For Sentinel Lymph Node Metastasis And Exploration Of Individualized Sentinel Lymph Node Biopsy In Breast Cancer

ObjectiveTo analyze the risk factors of SLN metastasis in breast cancer and verify the clinical application value of MSKCC nomogram,so as to provide ideas and reference for individualized axillary lymph node management in breast cancer patients.MethodsThe imaging and clinicopathological data of 454 patients with breast cancer who underwent SLNB in the First Affiliated Hospital of Chongqing Medical University from December 2017 to January 2019 were collected,and risk factors for SLN metastasis were retrospectively analyzed.Login the MSKCC sentinel node metastasis rate prediction model website,calculate the probability of sentinel node metastasis of each patient,the prediction accuracy of MSKCC nomogram was evaluated by drawing the ROC curve and calculating the AUC value.ResultsThe tumor size,mulifocality,lymphovascular invasion,pathological type,suspicious lymph nodes in ultrasound were significantly correlated with SLN metastasis(P< 0.05).Tumor size,suspicious lymph nodes in ultrasound,mulifocality,and lymphovascular invasion were independent risk factors for SLN metastasis(P< 0.05).The AUC value of the MSKCC model was 0.702.ConclusionPatients with a predicted sentinel lymph node metastasis rate of 14%or less could be considered to have no sentinel lymph node metastasis and ALND and SLNB could not be performed.Patients with a predictive value greater than or equal to 79% could be considered to have sentinel lymph node metastases without SLNB and go directly to ALND.The accuracy of MSKCC model in predicting SLN metastasis is high,but there are still some shortcomings,such as limited benefit population,inability to obtain preoperative access to lymph-vascular invasion,and no ultrasound for variables.