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Objective To analyze the relationship between non-sentinel lymph node ( NSLN ) metastases and clinicopathologic features in breast invasive ductal carcinoma patients with 1, 2 positive sentinel lymph node(SLN). Methods A total of one hundred and ninety-eight patients with breast invasive ductal carcinoma from January 2013 to December 2017 were enrolled in this prospective study. Modified radical mastectomy was performed after SLN1-2 positive cases were confirmed by biopsy. Postoperative NSLN was counted and the relationship between NSLN and clinical factors was analyzed. Results The positive rate of NSLN in 198 patients was 40. 9%(81/198),of which 80 cases were positive at axillary level I and only 1 case was positive at axillary level I and II. There was no significant correlation between NSLN positive and age (χ2＝1. 258),lesion grade (χ2＝1. 327),molecular typing (χ2＝1. 020),neoadjuvant chemotherapy (χ2＝0. 923),estrogen receptor (χ2＝0. 189),progesterone receptor ( χ2＝0. 109),Ki67 ( χ2＝1. 755) ( P＞0. 05). The positive rate of NSLN in HER-2 positive patients was 56. 9%(29/51),which was significantly higher than 35.4%(52/147) in HER-2 negative patients (χ2 ＝6.136,P＝0.034).Logistic regression analysis showed that HER-2 positive was an independent risk factor for NSLN ( OR＝0. 031,95%CI 0. 012－0. 615,P＝0. 022) . Conclusion The risk of NSLN positive in breast cancer patients such as SLN1-2 positive patients is still high,and the risk of NSLN positive in HER-2 positive patients is higher.
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Objective To study the clinical,pathological features and therapeutic method of metastatic triple negative breast cancer (TNBC) and its relationship with disease-free survival.Methods One hundred and thirty-six cases of metastatic TNBC patients who were treated from January 2007 to January 2012 in the Third People''s Hospital of Dalian were selected as research objects.All patients received operation and radiochemotherapy,the clinical,pathological features,therapeutic method,the survival rate within 3,5 years,and the metastasis and survival situation of the patients were analyzed.Results For the patients in clinical stage Ⅲ period,the survival rate within 3,5 years were 45.9%(17/37),37.8%(14/37),respectively,significantly lower than those in stageⅡperiod (89.9%(89/99),73.7%(73/99)),and the differences were statistically significant (χ2=18.459,12.681,P<0.01).The 3-year survival rate of the patients in pathological grade Ⅲ was 64.9%(37/57),5-year survival rate was 43.9%(25/57),significantly lower than those of gradeⅠ(91.7%(22/24),83.3%(20/24)) and grade Ⅱ(85.5%(47/55),76.4%(42/55)),the differences were statistically significant (χ2=14.728,12.450,P<0.05).The 3-year survival rate of radiotherapy group was 81.8%(27/33),significantly higher than that of the non-radiotherapy group (59.1%(13/22)),the difference was statistically significant (χ2=5.468,P<0.05).Lung,liver,brain,bone and supraclavicular lymph nodes were main distant metastasis,the survival time of patients with metastasis was less than 2 years.Conclusion Metastatic TNBC is a special type of breast cancer that is difficult to treat.Breast conserving surgery has certain application value,radiotherapy can only increase the 3 year survival rate.Pathological grade and clinical staging are the main prognostic factors.