Reviewer ’s report  
 
Title: Independent risk factors for axillary lymph node metastasis  in breast cancer patients with 
one or two positive sentinel lymph n odes 
 
Version: 1 Date: 28 Jan 2020  
 
Reviewer's report:  
 
Previously, i mentioned that "The title of the paper is mis -understanding. For my understanding, 
the author plans to find out risk factors for non -SLNs metastasis in SLN 1 -2+ patients. If it is 
true, the manuscript and tables should be revised accordingly. " for author further revision. 
However, the author answered as follows: "After having read your comment, we looked back at 
our original data. In fact, we intended to uncover the risk factors for axillary lymph node (ALN) 
metastasis, rather than non -sentinel lymph node (SLN) metastasis, using breast cancer patients 
with 1 -2 positive SLNs", which i think it was not appropriate. The author must correct his 
statement and the title of current submission can cause misunderstanding. All patients had 
positive ALN, how to identify the risk factors for ALN metastasis?  
Moreove r, I would like to know how much patients with 1 -2 positive SLNs who met with Z0011 
trial eligibilty did not receive further ALND in your center, which should be added in the revised 
manuscript.  
 
For the 4th question, the author answered that "Actually, th e cT1 -2N0 breast cancer patients 
were included in this cohort", which should be stated as only cT1 -2N0 can be included in this 
stud. cT1 -2N0 is an essential eligibilty criteria for this study, otherwise, the result of study added 
little value for clinical practice.  
 
Are the methods appropriate and well described?  
If not, please specify what is requ ired in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please  explain in your comments to the authors.  
 
Yes 
 
 
 
 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publi cation of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you curr ently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any  other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
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