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: 0 Date: 19 Oct 2019  
 
Reviewer's report:  
 
1. The title of the paper is mis -understanding. For my understa nding, 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.  
 
2. Several factors were associated with non -SLNs metastasis, how to interpret this data in clinical 
practice, especially in the post -ACOSOG Z0011 trial era.  
 
3. How many patients would be spared further ALND in your cohort after ACOSOG Z0011 trial 
data release?  
 
4. The eligibility of this study population should include patients with cT1 -2N0, o therwise, the 
clinical meaningful of this study is limited.  
 
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:  
 
Needs some language corrections before being published  
 
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.  
 
None  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload wi ll be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal