Predictive factors of avoiding axillary lymph node dissection in breast cancer patients with positive result of sentinel lymph node

Objective To investigate the predictive factors of further axillary lymph node dissection in patients with sentinel lymph node biopsy (SLNB)-positive breast cancer. Methods Clinical data about patients with breast cancer received SLNB in Chinese PLA General Hospital from January 2007 to November 2016 were retrospectively collected to investigate the predictive factors of avoiding further axillary lymph node dissection in SLNB-positive breast cancer patients. Results Of the 196 SLNB-positive patients, 121 (61.7%) patients had negative axillary lymph nodes' results and 75 had positive. In univariate analysis, there were significantly statistical differences between two categories in age (P=0.062), histological grade (P=0.009), number of positive sentinel lymph nodes (P=0.002) and pathological T staging (P=0.078). Multivariate analysis revealed that the number of positive sentinel lymph nodes (≥ 3 vs 1, OR=4.159, P=0.003) and histological grade of breast cancer (Ⅲ vs Ⅰ, OR=2.287, P=0.011) provided further indications for ALND. Conclusion Patients with one positive SLN or SBR gradeⅠ are recommended to be exempt from ALND and receive adjuvant therapy after surgery.