![]() ![]() Patients with SLN metastasis were examined by SLNB during surgery. We reviewed the clinicopathologic data of breast cancer patients with SLN metastasis who underwent SLNB during surgery at Harbin Medical University Cancer Hospital between Januand December 31, 2020. In addition, patients with a low risk of SLN metastasis could be exempt from SLNB. The goal of this retrospective study was to establish a predictive model that includes tumor volume, swollen axillary lymph nodes, pathological types, and risk subtypes for SLN metastasis in T1 breast cancers. So we enrolled 1,619 T1 breast cancer patients in this study and identified predictors for SLN metastasis in T1 breast cancers, especially the relationship between SLN metastasis and molecular subtypes. T1 patients with small tumors and lower SLN metastasis rates ( 14) are more likely to be exempt from SLNB. At the same time, the reports verified that tumor size was positively correlated with the SLN metastasis rate ( 13). Furthermore, whether SLNB should be performed for luminal A breast cancer is still controversial ( 12). Several studies have found a strong association between the molecular subtypes and the axillary status in breast cancer patients ( 10, 11). This raises the question of whether we can pinpoint who might avoid SLNB. However, approximately 65%–70% of patients have suffered from unnecessary invasive axilla surgery ( 8, 9). Therefore, SLNB can predict the metastasis status of ALNs with a low false-negative rate, allowing more patients to avoid upper limb pain, sensory loss, and lymphedema caused by axillary lymph node dissection ( 6, 7). It can be used as a treatment and prognostic factor for breast cancers ( 3– 5). SLN is the first regional lymph node from the primary tumor metastasis and the first lymph node capable of receiving lymph fluid from a specific organ and region ( 2). From the initial “expanded radical treatment” to “modified radical treatment,” and to the current “breast-conserving surgery,” all of them reflect that breast cancer surgery focuses not only on effective treatment, but also on maximizing aesthetics and minimizing trauma. Breast cancer treatment drugs are constantly evolving, as is the concept of surgery. These patients could be included in trials investigating the SLNB exemption.īreast cancer has the highest incidence rate among female malignant tumors, accounting for 24.2% of all new cases each year ( 1). The SLN metastasis rates of intraductal carcinoma and HER2 enriched are 2.05% and 6.67%. It showed excellent diagnostic performance (AUC = 0.773) in the validation cohort.Ĭonclusion: The HMU nomogram for predicting SLN metastasis incorporates four variables, including tumor volume, swollen axillary lymph nodes, pathological types, and molecular subtypes. A regression model based on the results of the multivariate analysis was developed to predict the risk of SLN metastasis, indicating an AUC of 0.798. Distance from nipple or surface and position of tumor have no effect on SLN metastasis. Tumor volume, swollen axillary lymph nodes, pathological types, and molecular subtypes were found to be independent predictors for SLN metastasis in multivariate regression analysis. Results: In the training cohort of 1,000 cases, the SLN metastasis rate was 23.8%. ![]() We selected the patients exempt from SLNB by using the nomogram. Through univariate and multivariate logistic regression analysis, we analyzed the tumor anatomical and clinicopathological factors and constructed the Heilongjiang Medical University (HMU) nomogram. Methods: A total of 1,619 T1 breast cancer patients with SLNB in our hospital were enrolled in this study. Considering the low rate of sentinel lymph node (SLN) metastasis in T1 breast cancer, this study aims to identify the characteristics of T1 breast cancer without SLN metastasis and to select T1 breast cancer patients who avoid SLNB through constructing a nomogram. 2School of Life Science and Technology, Computational Biology Research Center, Harbin Institute of Technology, Harbin, Chinaīackground and Objective: Sentinel lymph node biopsy (SLNB) is used to assess the status of axillary lymph node (ALN), but it causes many adverse reactions.1Department ofs Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China.Guozheng Li 1† Jiyun Zhao 2† Xingda Zhang 1† Xin Ma 1 Hui Li 1 Yihai Chen 1 Lei Zhang 1 Xin Zhang 1 Jiale Wu 1 Xinheng Wang 1 Yan Zhang 2* Shouping Xu 1*
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