title: [High risk factors of the third level of lymphatic metastasis in breast cancer patients received radical/modified mastectomy: an analysis of 746 cases].
abstract: OBJECTIVE
  To study the high risk factors of the third level of lymphatic metastasis in breast cancer patients to guide clinical practice.
  
  
  METHODS
  The clinical data of 746 breast cancer patients (all female, aged from 33 to 80 years with a median of 46 years) received radical or modified mastectomy between 2001 and 2011 was analyzed retrospectively. Eleven individual variables were selected to investigate high risk factors of the third level of lymphatic metastasis in different conditions.
  
  
  RESULTS
  Axillary nodes metastasis status (OR = 4.541, 95%CI:3.569-5.776), tumor site (OR = 1.437, 95%CI:1.029-2.007), external nodes involved (OR = 3.809, 95%CI:1.683-8.618) and estrogen receptor (OR = 0.740, 95%CI:0.569-0.964) were high risk factors of the third level of lymphatic metastasis. Further analysis found that it is prone to happen a metastasis, especially when the tumor with a size over 5 cm and located at the lateral quadrant. Negative estrogen receptor was a risk factor of the third level lymphatic metastasis along with the tumor stage.
  
  
  CONCLUSIONS
  For preoperative tumor biopsy shows Negative estrogen receptor of tumor stage T3 and over stage T3 when considering suspicious lymph node metastasis or external tissues metastasis intraoperatively should take in account into third level axillary lymph node dissection actively.
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Chunxiang
authors.initials: C
authors.lastname: Tian
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yuehe
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Hongjiang
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. Email: lqlq1963@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lyu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors