Development and validation of a pre- and intra-operative scoring system that distinguishes between non-advanced and advanced axillary lymph node metastasis in breast cancer with positive sentinel lymph nodes: a retrospective study

Table 2 Results of univariate and multivariate analyses of factors associated with advanced ALNM (pN2-N3) in the training cohort

Characteristics	Univariate			Multivariate
Characteristics	OR	95% CI	P value	OR	95% CI	P value
Age, years
< 40	1
≥ 40	1.74	0.60–5.02	0.307
Clinical tumor size
≤ 1 cm	1			1
1–2 cm	2.32	0.52–10.3	0.271	1.40	0.26–7.50	0.696
2–3 cm	3.59	0.82–15.8	0.090	1.20	0.22–6.44	0.828
3–4 cm	2.16	0.40–11.8	0.374	0.76	0.11–5.31	0.781
4–5 cm	11.6	2.41–55.6	0.002	4.94	0.80–30.5	0.086
> 5 cm	12.7	2.18–73.4	0.005	7.03	0.82–60.3	0.075
Histologic grade
1	1
2	1.37	0.70–2.67	0.362
3	1.37	0.66–2.87	0.398
Histologic type
IC-NST	1			1
ILC	2.88	1.50–5.52	0.001	2.31	0.94–5.69	0.068
IMPC	1.66	0.45–6.08	0.442	1.84	0.32–10.5	0.492
Others	0.60	0.08–4.78	0.634	0.38	0.04–3.83	0.441
Ki-67
≤ 10%	1
10–30%	1.24	0.60–2.57	0.568
≥ 30%	1.10	0.50–2.43	0.805
Subtype
HR-/HER2−	1
HR+/HER2−	0.80	0.32–2.02	0.640
HR+/HER2+	1.01	0.31–3.24	0.988
HR−/HER2+	0.39	0.04–3.59	0.405
Breast surgery
Breast-conserving surgery	1			1
Total mastectomy	2.20	1.26–3.83	0.005	1.30	0.63–2.70	0.481
No. of suspicious ALNs on US imaging^a
0	1			1
1 (solitary)	1.66	0.87–3.15	0.122	1.04	0.47–2.33	0.915
≥ 2 (multiple)	5.72	2.83–11.6	< 0.001	5.02	1.99–12.6	0.001
Size of SLN metastasis
ITC, micrometastasis	1			1
Macrometastasis	55.2	7.60–400	< 0.001	21.5	2.67–173	< 0.001
Ratio of no. of positive SLNs to total no. of SLNs
< 0.5	1			1
≥ 0.5	10.4	4.88–22.2	< 0.001	2.86	1.15–7.14	0.024
No. of positive SLNs
0 (ITC only), 1	1			1
2	8.25	4.50–15.1	< 0.001	3.05	1.47–6.34	0.003
3	39.7	15.9–98.9	< 0.001	15.7	5.56–44.2	< 0.001

IC invasive carcinoma, NST no special type, ILC invasive lobular carcinoma, IMPC invasive micropapillary carcinoma, HR hormone receptor, HER2 human epidermal growth factor receptor 2, ALND axillary lymph node dissection, ALN axillary lymph node, ALNM axillary lymph node metastasis, US ultrasound, ITC isolated tumor cells, SLN sentinel lymph node
^aAxillary lymph nodes were considered suspicious if at least one of the following were noted: diffuse cortical thickness > 5 mm, focal cortical thickness > 3 mm, and effacement or replacement of the fatty hilum on US imaging

ISSN: 1477-7819