Background The randomized trials which include ACOSOG Z0011 and IBCSG 23-01 had found that the survival rates were not different in patients with cT1/2N0 and 1–2 sentinel lymph node (SLN)-positive, macro/micrometastases who underwent breast-conserving therapy, and micrometastases who underwent total mastectomy (TM), when axillary lymph node dissection (ALND) was omitted. However, for patients with cT1/2N0 and 1–2 SLN macrometastases who underwent TM; there was still insufficient evidence from clinical studies to support whether ALND can be exempted. This study aimed to investigate the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1–2 SLN macrometastases undergoing TM. Methods The clinicopathological data of 1491 breast cancer patients who underwent TM and SLNB from January 2017 to February 2022 were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for nSLN metastasis. Results A total of 273 patients with 1–2 SLN macrometastases who underwent TM were enrolled. Postoperative pathological data showed that 35.2% patients had nSLN metastasis. The results of multivariate analysis indicated that tumor size (TS) (P = 0.002; OR: 1.051; 95% CI: 1.019–1.084) and ratio of SLN macrometastases (P = 0.0001; OR: 12.597: 95% CI: 4.302–36.890) were the independent risk factors for nSLN metastasis in breast cancer patients with 1–2 SLN macrometastases that underwent TM. The ROC curve analysis suggested that when TS ≤22 mm and ratio of SLN macrometastases ≤0.33, the incidence of nSLN metastasis could be reduced to 17.1%. Conclusions The breast cancer patients with cT1/2N0 stage, undergoing TM and 1–2 SLN macrometastases, when the TS ≤22 mm and macrometastatic SLN does not exceed 1/3 of the total number of detected SLN, the incidence of nSLN metastasis is significantly reduced, but whether ALND can be exempted needs further exploration.

Background Magnesium has been found to have a strong association with peripheral arterial disease (PAD), and dietary magnesium intake shows promise as a predictor of the condition. However, the relationship between low dietary magnesium intake and an increased risk of PAD remains uncertain, and further research is needed to clarify this relationship. Methods This study analyzed data from 5969 participants in the National Health and Nutrition Examination Survey (NHANES) of the United States from 1999 to 2004. Multifactorial logistic regression models were used to investigate the association between dietary magnesium intake and PAD. Results Participants with PAD had lower dietary magnesium intake compared to those without PAD. After adjusting for all covariates, dietary magnesium intake remained negatively associated with PAD (OR: 0.999, 95% CI: 0.998, 1.000). When dietary magnesium intake was divided into quartiles, compared with the fourth quantile, the first quartile is associated with a higher incidence rate of PAD (OR: 1.560, 95%CI: 1.019, 2.386). Subgroup analysis revealed that the link between dietary magnesium intake and PAD remained significant among specific subgroups, including non-white, never or former smokers, and non-hypertensive, non-diabetic individuals (P < 0.05). Conclusion Our study provides evidence that dietary magnesium intake is negatively associated with the incidence of PAD. Therefore, people with inadequate dietary magnesium intake, particularly those with excessively low intake, should increase their magnesium intake to reduce the risk of PAD.

Backgrround The randomized trials include ACOSOG Z0011 and IBCSG 23 − 01 had found that, the survival rates were not different in patients with cT1/2N0 and 1–2 sentinel lymph node (SLN) positive, macro/micro metastases who underwent breast-conserving therapy and micrometastases who underwent total mastectomy (TM), when axillary lymph node dissection (ALND) was omitted. However, for patients with cT1/2N0 and 1–2 SLN macrometastases who underwent TM, there was no published clinical research evidence whether ALND can be exempted. This study aimed to investigate the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1–2 SLN macrometastases undergoing TM. Methods The clinicopathological data of 1491 breast cancer patients underwent TM and SLNB from January 2017 to February 2022 were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for nSLN metastasis. Results A total of 273 patients with 1–2 SLN macrometastases underwent TM were enrolled. Postoperative pathological data showed that 35.2% patients had nSLN metastasis. The results of multivariate analysis indicated that tumor size (TS) (P = 0.002; OR: 1.051; 95% CI: 1.019–1.084) and ratio of SLN macrometastases (P = 0.0001; OR: 12.597: 95% CI: 4.302–36.890) were the independent risk factors for nSLN metastasis in breast cancer with 1–2 SLN macrometastases underwent TM. The ROC curve analysis suggested that when TS ≤ 22mm and ratio of SLN macrometastases ≤ 0.33, the incidence of nSLN metastasis could be reduced to 17.1%. Conclusions The breast cancer patients with cT1/2N0 stage, undergoing TM and 1–2 SLN macrometastases, when the TS ≤ 22mm and macrometastatic SLN does not exceed 1/3 of the total number of detected SLN, the incidence of nSLN metastasis is significantly reduced, and whether ALND can be exempted deserves further exploration.