Preoperative Imaging Evaluation Of Axillary Lymph Nodes In Early Breast Cancer And Analysis Of Influencing Factors Of False Negative Preoperative Examination

Objective: To explore the clinical value of preoperative non-invasive imaging in judging axillary lymph node metastasis,and to analyze the risk factors of axillary lymph node metastasis in breast cancer patients,so as to provide experimental data and theoretical basis for the precise treatment of breast cancer and the formulation of individualized treatment strategies.Methods: A retrospective analysis was made of 142 patients with early breast cancer(cT1-2N0M0)who underwent axillary lymph node dissection in the Tumor Hospital of Xinjiang Medical University.Before operation,all patients underwent breast magnetic resonance examination and axillary ultrasonography.After operation,axillary lymph nodes were routinely sent for pathological examination.The pathological results were gold standard.The sensitivity and specificity of preoperative examination in judging axillary lymph node metastasis were calculated.The correlation between preoperative examination and postoperative pathological results was observed.The independent risk factors of axillary lymph node metastasis in breast cancer patients were analyzed by univariate analysis and multivariate analysis combined with general data of patients and pathological characteristics of primary tumors.Results: The average age of142 cases was 48.8�9.6 years.Of them,67 cases had axillary lymph node confirmed by pathology and 75 cases had no axillary lymph node metastasis.Among them,69 cases were diagnosed axillary lymph node metastasis by magnetic resonance examination,73 cases were without axillary lymph node metastasis,114 cases were consistent with pathological results after operation,the sensitivity and specificity of magnetic resonance examination were 80.60% and 80.00%,64 cases were diagnosed axillary lymph node metastasis by axillary ultrasonography,78 cases were without axillary lymph node metastasis,97 cases were consistent with pathological results after operation,and the sensitivity and specificity of ultrasonography were 64.18%,respectively.It is 72%.Axillary lymph node status is closely related to the surgical methods and treatment strategies.In the clinical diagnosis and treatment of patients with risk factors of axillary lymph node metastasis,the accuracy of axillary lymph node diagnosis can be improved by combining the results of nuclear magnetic resonance and B-mode ultrasonography.The univariate analysis of risk factors for axillary lymph node metastasis showed that body mass index(BMI),tumor size,vascular invasion,PR,Her-2 and Ki-67 were independent risk factors for axillary lymph node metastasis(P < 0.05).Multivariate analysis showed that BMI,tumor size,vascular metastasis,PR and Ki-67 were independent risk factors for axillary lymph node metastasis of breast cancer.Conclusion: For breast diseases,magnetic resonance examination is more sensitive and accurate than ultrasound examination.When breast cancer patients have BMI,tumor size,vascular invasion,PR,Her-2,Ki-67 and other independent risk factors affecting axillary lymph node metastasis,combined with ultrasound and magnetic resonance examination results can improve the preoperative diagnosis of axillary lymph node metastasis.