Abstract: Abstract: Objective To explore the feasibility of omitting axillary lymph node dissection (ALND) in early breast cancer patients with positive sentinel lymph nodes (SLN). Methods Clinical data of 591 patients with primary breast cancer treated in our hospital from September 2014 to September 2016 were collected. According to the SLN status, patients were divided into SLN (-) group (n=320), SLN (+) =1 group (n=172), SLN (+)=2 group (n=72) and SLN≥3 group (n=27). ALND was performed in all patients after sentinel lymph node biopsy (SLNB). The positive rates of axillary lymph node (ALN) were compared between groups. Results The positive rates of ALN were 5.0% (16/320), 8.1% (14/172), 16.7% (12/ 72) and 37.0%(10/27) in SLN (-) group, SLN (+) =1 group, SLN (+)=2 group and SLN≥3 group respectively. There was no significant difference in the positive rate of ALN between SLN (-) group and SLN (+) =1 group (χ2 =1.926， P=0.165). The positive rate of ALN was significantly higher in SLN (+)=2 group than that of SLN (-) group (χ2 =12.062， P=0.001) and SLN (+) =1 group (χ2 =3.876， P=0.049). The positive rate of ALN was significantly higher in the SLN(+)≥3 group than that in the SLN(-) group (χ2 =32.939, P＜0.001) and SLN(+)=1 group (χ2 =15.751, P＜0.001) and SLN(+) =2 group (χ2 =4.714, P=0.030). Conclusion The patients with 1 SLN positive can be considered to exempt from ALND, while the patients with 2 or more SLN positive may be recommended ALND.

Key words: breast neoplasms, sentinel lymph node biopsy, lymph node excision, axillary lymph node dissection