Omitting ALND Is Not Safe for a Cohort of Early-Stage Breast Cancer Patients with 1-2 SLNs Macro-Metastases and Breast-Conserving Therapy: A Single-Center Retrospective Study

Background: omitting axillary lymph node dissection (alnd) is recommended for early-stage breast cancer patients with 1-2 sentinel lymph nodes (slns) macro-metastases and breast-conserving therapy. however, it is not safe for part of patients, so it is significant to find risk factors and develop a predictive model of non-slns metastases in breast cancer patients with 1-2 slns macro-metastases and breast-conserving therapy. methods: this retrospective study enrolled 228 breast cancer patients with 1-2 slns macro-metastases who underwent alnd and breast-conserving surgery between jan 2012 and dec 2017 at cancer hospital chinese academy of medical sciences. chi-square test and backward stepwise binary logistic regression were used to find factors that influenced non-sln metastases, then a predictive model was formulated and obtained its area under the curve. results: tumor pathologic invasion size, number of positive slns and aln status on imaging was associated with non-slns metastases. the predictive model was also formulated based on these three factors to assess and the area under the curve of model was 0.708. conclusion: we developed a predictive model to assess the high-risk cohort of patients of non-slns metastases which can be an auxiliary tool for doctors.