Background: To explore the predictive value of vascular endothelial
growth factor (VEGF)-C and D combined with ultrasonic pathological features for
nonsentinel lymph node (NSLN) metastasis in positive sentinel lymph nodes (SLNs)
early-stage breast cancer. Methods: To review the clinical data of 170
SLN-positive early breast cancer patients. We examined VEGF-C and D positive
expression in cancerous and paraneoplastic tissues and counted ultrasound and
pathological features. Results: The rate of VEGF-C and D positivity in
cancer tissues was higher than that in paracancerous tissues (p
0.05). The rates of VEGF-C and D positivity in the cancer tissues with vascular
infiltration, number of SLN positives 2, proportion of SLN positives 0.5,
burr sign on ultrasound, and NSLN metastasis were higher than those of patients
without vascular infiltration, number of SLN positives 2, proportion of
SLN positives 0.5, no burr sign, and no NSLN metastasis, respectively
(p 0.05). The results also showed that the presence of vascular
infiltration and burr sign, a high number of SLN positivity, the percentage of
SLN positivity 0.5, VEGF-C and D positivity were all NSLN metastasis
independent risk factors for metastasis (p 0.05). Receiver operating
characteristic (ROC) curve analysis showed that the area under the ROC curve
(AUC) for VEGF-C and D combined with ultrasound and pathological features to
predict NSLN metastasis was the highest. Conclusions: The ultrasound and
pathological features of SLN-positive early breast cancer patients, such as
vascular infiltration, VEGF-C and D positivity, were all independent risk factors
for NSLN metastasis, and VEGF-C and D combined with ultrasound and pathological
features had high predictive efficacy for NSLN metastasis. It provides reliable
indicators to screen for NSLN metastasis in a high-risk group from SLN-positive
patients with early-stage breast cancer.
