J Breast Cancer.  2015 Jun;18(2):167-172. 10.4048/jbc.2015.18.2.167.

Treatment Outcome of Breast Cancer with Pathologically Proven Synchronous Ipsilateral Supraclavicular Lymph Node Metastases

• Jung J
• Kim SS
• Ahn SD
• Lee SW
• Ahn SH
• Son BH
• Lee JW
• Choi EK

• KMID: 2374532
• DOI: http://doi.org/10.4048/jbc.2015.18.2.167

Abstract

PURPOSE
The aim of this study was to investigate the prognosis, patterns of failure, and prognostic factors for breast cancer patients with pathologically proven synchronous ipsilateral supraclavicular lymph node (ISCLN) metastases.
METHODS
We reviewed the records of breast cancer patients with pathologically proven ISCLN metastases. Local aggressive treatment was defined as treatment including surgery, axillary lymph node dissection (ALND), ISCLN excision, radiotherapy (RT), and chemotherapy.
RESULTS
A total of 111 patients were included. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 64.2% and 56.2%, respectively. On univariate analysis, RT, ALND, trastuzumab treatment, hormone receptor (HR) status, and local aggressive treatment were identified as significant factors for OS. The 5-year OS for 73 patients who received local aggressive treatment was superior to that of 38 patients who received nonaggressive treatment (70.9% vs. 49.3%, p=0.036). Multivariate analysis showed that RT, HR status, and trastuzumab were significant variables for the 5-year OS and DFS.
CONCLUSION
Multimodality treatment with surgery, taxane-based chemotherapy, hormone therapy, and RT is strongly recommended for breast cancer patients with synchronous ISCLN metastases.

Keyword

Breast neoplasms; Lymph nodes; Neoplasm metastasis; Radiotherapy

MeSH Terms

Breast Neoplasms*
Disease-Free Survival
Drug Therapy
Humans
Lymph Node Excision
Lymph Nodes*
Multivariate Analysis
Neoplasm Metastasis*
Prognosis
Radiotherapy
Treatment Outcome*
Trastuzumab

Figure

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  Figure 1 Kaplan-Meier estimates of overall survival and disease-free survival for all patients with supraclavicular lymph node metastases (n=111).

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  Figure 2 Kaplan-Meier estimates of survivals for patients treated with local aggressive treatment (n=73) or nonaggressive treatment (n=38). (A) Overall survival (OS). (B) Locoregional failure-free survival (LRFFS). (C) Distant failure-free survival (DFFS).

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