Correlation Analysis Of Axillary Lymph Node Status After Neoadjuvant Chemotherapy For Breast Cancer

Objective: To analyze the contributing factors that affect axillary lymph node metastasis of breast cancer patients after preoperative chemotherapy,discuss whether axillary lymph node dissection can be avoided in patients without certain risk factors after neoadjuvant chemotherapy,and provide a theoretical basis for sentinel lymph node biopsy after chemotherapy.Method: The clinical and pathological data of 134 breast cancer patients were collected from September 2018 to December 2019 of Liaoning Cancer Hospital.The clinical stage of the patients was T1-3N0-1M0 and all patients received surgical treatment followed by neoadjuvant chemotherapy.The clinical and pathological data of patients were retrospectively analyzed,X2 test and Fisher exact probability method were used to analyze the influencing factors of axillary lymph node metastasis after neoadjuvant chemotherapy and influencing factors of axillary lymph node pathological complete response after neoadjuvant chemotherapy respectively.And the independent influencing factors were analyzed by binary logistic regression respectively,with drawing curve.Result:The axillary nodes metastasis after neoadjuvant chemotherapy was related with whether breast pathological complete response,clinical axillary node metastasis or not,HER2 expression,molecular subtype(P<0.05).Three factors,breast lesion not pathological complete response,clinical axillary node metastasis,and luminal B breast cancer,are independent risk elements of axillary nodes metastasis after neoadjuvant chemotherapy.The area under the ROC curve are 0.716(95%CI 0.628-0.804,P<0.05)、0.626(95%CI 0.531-0.721,P<0.05)、0.578(95%CI 0.480-0.676,P<0.05).Whether breast pathological complete response,ER expression level,HER2 level,molecular subtype are relation to axillary pathological complete response of c N1 patients who underwent neoadjuvant chemotherapy(P<0.05).The breast lesion not pathological complete response is the only independent risk factor of c N1 patients who underwent neoadjuvant chemotherapy(P<0.05).Conclusion:The c N1 breast cancer patients who got breast pathological complete response after neoadjuvant chemotherapy except molecular subtyping of luminal B,could have sentinel lymph node biopsy.The breast cancer patients whose axillary clinical stage was c N1 and got breast pathological complete response after neoadjuvant chemotherapy can be considered to implement sentinel lymph node biopsy with overall consideration of patients carefully.