| Background&objective:At present,breast cancer has become the most common malignant tumor in women,the incidence rate is becoming increasingly high.With the awareness of breast cancer and the promotion of early screening,the detection rate of early breast cancer is increasing.Early breast cancer patients often have no obvious lymph node or distant metastasis,and the prognosis is better.However,there are still 20-30 percent of patients with distant metastasis years later,which arouses the concern of researchers.Up to now,the prognostic effect of number of axillary lymph nodes dissected for lymph node-negative breast cancer patients is still controversial.It is necessary to further explore the clinicopathological characteristics and prognostic factors of axillarv-node-negative breast cancer under different dissection numbers of axillary nodes,so as to provide more clinical strategies for the treatment of axillarv-node-negative breast cancerMethods:Selecting breast cancer patients with lymph node negative who underwent axillary lymph node dissection in 2010 and 2011 by the SEER(Surveillance.Epidemiology.and End Results)database,and used X-Tile to analyze the appropriate cut-off points for the number of negative lymph nodes,and further analysis was performed according to the cut-off points.Then we analyzed distributive differences of breast cancer patients with negative axillary lymph nodes in different negative lymph node groups with relevant clinical case information of patients obtained and adopted Kaplan-Meier survival curve to draw survival curve.Univariate and multivariate Cox regression models analyzed prognostic factors associated with axillary lymph node-negative breast cancer.The endpoint were the overall survival(OS)and breast cancer-specific survival(BCSS).When the P value less than 0.05,the differences were statistically significantResults:A total of 41.419 patients were included in the study.Using X-tile software,it was found that the negative lymph node 7 was the appropriate cut-off point,so the patients were divided into two groups.of which 36067 were negative lymph nodes<7 groups,and 5352 were negative lymph nodes>7.The Kaplan-Meier survival curve showed that the number of different negative lymph nodes had an important prognostic effect on OS and breast cancer-specific survival BCSS in axillary-node-negative breast cancer(OS:P<0.001,BCSS:P<0.001).among them,the number of negative lymph nodes<7 patients had a good prognosis in terms of OS and BCSS.and the 5-year OS and BCSS were 94.0%and 97.5%,while the prognosis of patients with negative lymph nodes>7 was poor,and their 5-year OS and BCSS were 89.4%and 94.5%,respectively.Multivariate results showed that patients’ age.race,marital status.histological grade,pathological stage,mass stage,molecular typing,and radiotherapy and chemotherapy were important factors influencing the prognosis of patients with axillary lymph node-negative breast cancer.The number of negative lymph nodes is an important independent prognostic factor in patients with axillary lymph node-negative breast cancer.However,when the tumor stage was at T4.it was not statistically significantConclusions:(1)The negative lymph node number among breast cancer patients with negative axillary lymph nodes is an independent prognostic factor of axillary lymph node negative breast cancer.With NLN=7 as critical point,patients with negative lymph node number<7 have a better prognosis,while patients with negative lymph node number>7 have a poor prognosis.(2)Clinically,for early breast cancer and tumor stage is T1-T3,excessive axillary lymph node dissection is unnecessary,and the operative strategy should be determined after fully evaluating the prognosis of patients before and during the operation.(3)Age,race,marital status,histological grade.pathological stage.tumor stage,molecular typing,chemoradiotherapy are important independent factors affecting prognosis for breast cancer patients with negative axillary lymph nodes. |
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