Sentinel淋巴结（SLN）活检是目前评估腋窝淋巴结（ALN）肿瘤负荷的标准方法。然而，并非所有的SLN+患者都有ALN转移。SLN特征的预后意义尚不清楚。我们旨在评估ALN转移的预测因子和SLN特征的临床价值。共纳入228例SLN +和228例SLN-（具有匹配的年级和年级）病例。根据ALN状态和结果分析了SLN、ALN和原发肿瘤的临床病理特征、治疗数据和生存数据。除了更大的肿瘤大小和存在LVI（两个P群体之间没有显着差异的<0.001）之外，在SLN-和SLN+病例中没有发现显着差异。只有31.8%的SLN+病例进行ALN切除手术后才被发现有ALN转移。SLN中的巨转移（MaM），淋巴结外扩张（ENE），更深层次的肿瘤侵袭和更多的SLN +淋巴结与ALN转移有关（P ≤ 0.025）。此外，孤立的肿瘤细胞（ITC）和SLN中的肿瘤侵袭程度分别是无病生存和乳腺癌特异生存的独立不良预后特征。有趣的是，位于亚包膜区的ITC的病例较皮质区者的生存率较高（OS：χ2 = 4.046，P = 0.044）。我们的研究确定了SLN中的多个特征，如SLN中的肿瘤侵袭程度和肿瘤大小，可作为预测ALN转移和乳腺癌转归的有用模型。ITC的存在，特别是在SLN中更深入的侵袭，预示着更糟糕的预后。应该注意他们的治疗。©2023 John Wiley＆Sons Ltd。

Sentinel lymph node (SLN) biopsy is the current standard assessment for tumour burden in axillary lymph node (ALN). However, not all SLN+ patients have ALN metastasis. The prognostic implication of SLN features is not clear. We aimed to evaluate predictive factors for ALN metastasis and the clinical value of SLN features.A total of 228 SLN+ and 228 SLN- (with matched year and grade) cases were included. Clinicopathological features in SLN, ALN and primary tumours, treatment data and survival data were analysed according to ALN status and outcome. Except for larger tumour size and the presence of LVI (both P < 0.001), no significant differences were found in SLN- and SLN+ cases. Only 31.8% of SLN+ cases with ALN dissection had ALN metastasis. The presence of macrometastases (MaM), extranodal extension (ENE), deeper level of tumour invasion in SLN and more SLN+ nodes were associated with ALN metastasis (P ≤ 0.025). Moreover, isolated tumour cells (ITC) and level of tumour invasion in SLN were independent adverse prognostic features for disease-free survival and breast cancer-specific survival, respectively. Interestingly, cases with ITC located in the subcapsular region have better survival than those in cortex (OS: χ2  = 4.046, P = 0.044).Our study identified features in SLN, i.e. the level of tumour invasion at SLN and tumour size in SLN as useful predictors for both ALN metastasis and breast cancer outcome. The presence of ITC, particularly those with a deeper invasion in SLN, portended a worse prognosis. Proper attention should be taken for their management.© 2023 John Wiley & Sons Ltd.