Risk factors of non-sentinel lymph node metastasis in breast cancer patients with positive sentinel lymph nodes

Objective: To analyze the risk factors for non-sentinel lymph node (nSLN) metastasis in patients with sentinel lymph node-positive breast cancer. Methods: A retrospective analysis was performed on 154 breast cancer patients admitted to our hospital with SLN positive and axillary lymph node dissection. According to weather nSLN metastasis occurred or not, patients were divided into 2 groups : nSLN metastasis negative (nSLN-group,81 cases)and nSLN metastasis positive(nSLN+group,73cases).Univariate and multivariate Logistic regression were used to analyze risk factors for nSLN metastasis. Results: The rate of non-sentinel lymph node metastasis in patients was 47.4% (73/154). Univariate analysis showed that primary tumor T staging, vascular invasion, number of SLN positive, human epidermal growth factor receptor-2, neutrophils/lymphocytes ratio (NLR), and platelets/lymphocytes ratio (PLR) were associated with non-sentinel lymph node metastasis. Further multivariate Logistic regression analysis showed that primary tumor T stage (P=0.040, OR=2.235), NLR (P=0.021, OR=2.073), and number of SLN metastasis (P=0.008, OR=3.763) were independent risk factors for nSLN metastasis. Conclusions: High T stage of primary tumor, NLR>2.82, and the number of SLN>2 are independent risk factors for nSLN metastasis in SLN-metastasis. For patients with risk factors above mentioned,application of axillary lymph node dissection are more important in them