Analysis on factors associated with axillary lymph node negativity and prognosis after neoadjuvant chemotherapy in breast can-cer patients
Objective This study aims to investigate the factors associated with axillary lymph node negativity in breast cancer patients following neoadjuvant chemotherapy(NAC),as well as the relationship between these factors and patient prognosis.Methods A retrospective analysis was conducted on the clinicopathological data of 179 patients who underwent NAC followed by curative breast cancer surgery at the Jiaxing Maternity and Child Health Care Hospital from January 2011 to December 2021.Based on the axillary lymph node status post-NAC,patients were divided into two groups:a negative group comprising 74 patients and a positive group consisting of 105 patients.The clinical and pathological characteristics between these two groups were compared and independent predictors of axillary lymph node negativity were identified using multivariable logistic regression analysis.Additionally,the relationship between axillary lymph node status post-NAC and patients'relapse-free survival and overall survival was explored through Kaplan-Meier survival curve analysis.Results In this study,no significant differences were observed between the two patient groups in age,body mass index,menstrual status,the maximum diameter of the initial tumor,tumor location,pathological type,progesterone receptor status,expression of Ki-67,human epidermal growth factor receptor 2 status,and chemotherapy regimen(all P>0.05).The initial axillary lymph node negativity status(P<0.001),estrogen receptor(ER)negativity(P=0.027),and pathologic complete response(pCR)in the breast post-NAC(P<0.001)were identified as independent predictors of axillary lymph node negativity after NAC.Furthermore,patients in the axillary lymph node-negative group exhibited significantly higher 5-year relapse-free survival rates(84.2%vs.67.5%,P<0.01)and 5-year overall survival rates(93.7%vs.77.7%,P<0.01)than those of the positive group.Conclusion Patients exhibiting initial axillary lymph node negativity,ER negativity,and pCR in the breast following NAC demonstrates a higher likelihood of post-NAC axillary lymph node negativity.This finding suggests that under these conditions,the utilization of sentinel lymph node biopsy for further evaluation of axillary status may be considered.Moreover,the axillary lymph node status post-NAC may serve as a significant prognostic indicator for patient outcomes.
Breast cancerNeoadjuvant chemotherapyNegative axillary lymph nodePrognosis