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Abstract:

Objective To explore the effect of extracapsular nodal extension（ENE）on axillary nodal metastasis burden and survival in breast cancer patients with 1 or 2 positive sentinel lymph nodes（SLNs）. Methods A total of 85 T1⁃2 breast cancer patients with 1 or 2 positive SLNs having undergone axillary lymph nodes dissec⁃ tion were divided into three groups：non⁃ENE，micro⁃ENE（≤ 2 mm）and macro⁃ENE（> 2 mm）. Correlations of extents of ENE with axillary nodal metastasis burden and prognosis of these patients were explored. Results The total number of metastatic lymph nodes significantly elevated（P < 0.05）and the number of non⁃SLSs was significantly higher than that of the non⁃ENE group（P < 0.05）. By Unadjusted Kaplan⁃Meier analysis the prognosis of patients with ENE ≤ 2 mm or > 2 mm was significantly poorer than that of the patients without ENE（P < 0.05， respectively）. Multivariate analysis showed that nodal metastasis on more than 3 LNs and the size of ENE > 2 mm were both the independent predictors for overall survival（P < 0.05）. Conclusion Presence of ENE on SLN is associated with increased nodal burden. Extranodal extension on sentinel lymph nodes to different extents renders dif⁃ ferent influences on the prognosis of patients with 1 or 2 ENE⁃positive SLNs. Therefore，it is needed to standardize 

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