Risk Factors And Establishing Predictive Risk-scoring Model For Axillary Lymph Node Metastasis In Early Breast Cancer

Objective:To explore the independent risk factors of axillary lymph node metastasis in early breast cancer and establishing an effective risk prediction model.Method:The clinical data of 404 early breast cancer patients from June 2016 to December 2017 in Liaoning Cancer Hospital were enrolled in this study.The chi-square test or Fisher’s exact test were used to analyze the clinical pathological characteristics and axillary lymph node metastasis.Multivariate stepwise logistic regression analysis was used to explore the independent risk factors of axillary lymph node metastasis.Risk prediction model was established according to the regression coefficients of each risk factor.ROC curve was used to verify the effectiveness of the test and calibration curve was drawn to evaluate its consistency with the real situation.Results:Axillary lymph node metastasis in early breast cancer was significantly different(P<0.05)between tumor size,pathological grade,vascular invasion,ER expression,size of KI67,molecular subtype and total number of lymph nodes≥14(14were the average number of lymph nodes),but not related to age,menopause,tumor location,pathological type,PR and other factors(P>0.05).Univariate and multivariate analysis showed that tumor>2 cm,pathological grade III,vascular invasion and ER expression≧50%were independent risk factors for axillary lymph node metastasis in early breast cancer(P<0.05).The area under the ROC curve was 0.852(95%CI was(0.812,0.892),P<0.01).The calibration curve R~2=0.9086(P<0.05).Conclusion:Tumor>2cm,pathological grade III,vascular invasion,and ER≧50%are independent risk factors for axillary lymph node metastasis in early breast cancer.