Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China.
Cancer Med. 2024 May;13(9):e7248. doi: 10.1002/cam4.7248.
Sentinel lymph node biopsy (SLNB) is a common choice for axillary surgery in patients with early-stage breast cancer (BC) who have clinically negative lymph nodes. Most research indicates that obesity is a prognostic factor for BC patients, but studies assessing its association with the rate of positive sentinel lymph nodes (SLN) and the prognosis of patients with early BC undergoing SLNB are limited.
Between 2013 and 2016, 7062 early-stage BC patients from the Shanghai Cancer Center of Fudan University were included. Based on the Chinese Body Mass Index (BMI) classification standards, the patients were divided into three groups as follows: normal weight, overweight, and obese. Propensity score matching analysis was used to balance the baseline characteristics of the participants. Logistic regression analysis was used to determine the association between obesity and positive SLN rate. Cox regression analysis was used to investigate whether obesity was an independent prognostic factor for early-stage BC patients who had undergone SLNB.
No significant association was observed between obesity and positive SLN rate in early-stage BC patients who had undergone SLNB. However, multivariate analysis revealed that compared to patients with normal BMI, the overall survival (hazard ratio (HR) 2.240, 95% confidence interval (CI) 1.27-3.95, p = 0.005) and disease-free survival (HR 1.750, 95% CI 1.16-2.62, p = 0.007) were poorer in patients with high BMI.
Obesity is an independent prognostic factor for early-stage BC patients who undergo SLNB; however, it does not affect the positive SLN rate.
前哨淋巴结活检（SLNB）是临床腋窝淋巴结阴性的早期乳腺癌（BC）患者腋窝手术的常用选择。大多数研究表明肥胖是 BC 患者的预后因素，但评估其与前哨淋巴结（SLN）阳性率和接受 SLNB 的早期 BC 患者预后之间关系的研究有限。
纳入 2013 年至 2016 年期间来自复旦大学上海癌症中心的 7062 例早期 BC 患者。根据中国 BMI 分类标准，将患者分为三组：正常体重、超重和肥胖。采用倾向评分匹配分析来平衡参与者的基线特征。采用 logistic 回归分析确定肥胖与 SLN 阳性率之间的关联。采用 Cox 回归分析来研究肥胖是否是接受 SLNB 的早期 BC 患者的独立预后因素。
在接受 SLNB 的早期 BC 患者中，肥胖与 SLN 阳性率之间没有显著关联。然而，多变量分析显示，与 BMI 正常的患者相比，肥胖患者的总体生存率（危险比（HR）2.240，95%置信区间（CI）1.27-3.95，p=0.005）和无病生存率（HR 1.750，95% CI 1.16-2.62，p=0.007）较差。
肥胖是接受 SLNB 的早期 BC 患者的独立预后因素；然而，它并不影响 SLN 阳性率。
