目的：探究初始腋窝淋巴结阳性乳腺癌患者在行新辅助化疗（neoadjuvant chemotherapy, NAC）之后腋窝淋巴结病理完全缓解（pathological complete response, apCR）的预测因素。方法：回顾性地收集了181例穿刺活检病理证实淋巴结阳性，并且在NAC后进行腋窝淋巴结手术的乳腺癌患者的个人特征及临床、病理特征进行单因素和多因素统计分析。结果：人表皮生长因子受体2（human epidermal growth factor receptor 2 , HER2）阳性（OR 2.19，95%CI 1.06-4.50），Ki67高表达（OR 3.79，95%CI 1.02-14.02），NAC后达到乳腺pCR（OR 2.82，95%CI 1.31-6.06）的患者更有可能达到腋窝淋巴结pCR。结论：HER2阳性、Ki67高表达和达到乳腺pCR的亚型可以是腋窝淋巴结pCR的预测因子，而脉管浸润与腋窝淋巴结pCR的概率较低有关。在HER2阳性亚组中，接受抗HER2靶向治疗可以有效提高腋窝淋巴结pCR率，且达到乳腺pCR和无脉管浸润与腋窝淋巴结pCR相关。在HR阳性亚组中，较低的cT分期和无脉管浸润与腋窝淋巴结pCR相关。

Objective: To identify the predictive factors for axillary pathological complete response (pCR) in patients with node-positive breast cancer who have undergone neoadjuvant chemotherapy (NAC). Methods: In this retrospective study, we analyzed a total of 181 patients who had been diagnosed with node-positive breast cancer via needle biopsy and subsequently underwent NAC followed by axillary curative surgery, using univariate χ2 test and multivariate logistic regression. Results: Patients with HER2-positive breast cancer (OR 2.19, 95% CI 1.06–4.50), high Ki67 expression (OR 3.79, 95% CI 1.02–14.02), and those who achieved breast pCR after NAC (OR 2.82, 95% CI 1.31–6.06) were more likely to achieve axillary pCR. Conclusion: The results of our study indicate that the HER2-positive subtype, high Ki67 expression, and achieving breast pCR are predictive factors for axillary pCR after NAC. In contrast, the presence of vascular invasion was associated with a lower probability of axillary pCR. Among patients with HER2-positive breast cancer, accepting HER2-targeted treatment was found to effectively increase the axillary pCR rate. Among patients with HR-positive breast cancer, an early tumor stage and without vascular invasion was associated with a higher probability of axillary pCR.