Factors associated with level III lymph nodes positive and survival analysis of its dissection in patients with breast cancer

Abstract

Objective: Surgical resection remains the mainstream radical therapy in patients with breast cancer. Given that no consensus has been reached on the exact indication for level III lymph node dissection, the aim of this study is to explore factors associated with level III lymph nodes positive and survival analysis of its dissection in patients with breast cancer. Materials and methods: A retrospective study including 61 patients after level I-III dissection via a smaller incision of pectoralis major and 61 patients experiencing only level I and II clearance was performed. Clinicopathological outcomes were compared initially and survival analysis was conducted subsequently. Results: No significant differences were presented in baseline and clinicopathological characteristics between the two groups. Ten (16.4%) patients’ level III nodes were proven positive after level III dissection. Positive nodes in level I and II lymph nodes over 9 was demonstrated as an independent predictor of level III nodes positive (OR:200.75 [95% CI:7.77–5187.19], p = 0.001). Although the level I-III lymph node dissection group presented a seemingly better disease-free survival, statistical significance was not detected (p = 0.21). Conclusions: This study revealed that having positive nodes in level I and II lymph nodes over 9 was a risk factor of level III lymph nodes positive. But level III lymph node dissection does not offer definite survival benefit.

Keywords

• Breast cancer
• Lymph node dissection
• Disease-free survival