关键词: 乳腺癌, 前哨淋巴结, 腋窝低位淋巴结, 临床解剖学

Abstract: Objective To study lower axillary lymph node dissection in patients of breast cancer with negative sentinel lymph node (SLN). Methods From January 2015 to January 2017, a total of 718 patients of breast cancer with negative SLN had mastectomy and lower axillary lymph node dissection in both our department and Department of Surgery Comprehensive Breast Health Center Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Metastasis rate of lower axillary lymph node and the factors related to metastasis were analyzed. Results Lower axillary lymph node was identified in 686 cases (95.5%) with (9.35±5.684) (0~21) lymph node per patients on average. Metastasis to lower axillary lymph nodes was found in 40 patients (5.6%, 40/718). Single-variant analysis showed that metastasis of lower axillary lymph nodes was related to enlarged axillary lymph nodes, number of SLN biopsy, tumor vascular thrombus, nerve invasion, HER2 positive, and molecular classification (P<0.05). Independent risk factors associated with lower axillary lymph node metastasis were shown in multivariate Logistic analysis including enlarged axillary lymph nodes, number of SLN biopsy, tumor vascular thrombus, nerve invasion, and molecular classification. There were 5 (0.7%) cases with postoperative upper limb lymphedema, and upper limb dysfunction was not found. Conclusions Metastasis of lower axillary lymph node was present combined with multiple risk factors in the patients of breast cancer with negative SLN and should be dissected.

Key words: Breast cancer, Sentinel lymph node, Low axillary lymph node, Clinical anatomy rate