Clinicopathological features of breast cancer patients with internal mammary and/or supraclavicular lymph node recurrence without distant metastasis

Abstract

Background Internal mammary and/or supraclavicular (IM–SC) lymph node (LN) recurrence without distant metastasis (DM) in patients with breast cancer is rare, and there have been few reports on its clinical outcomes. Methods We enrolled 4237 patients with clinical stage I–IIIC breast cancer treated between January 2007 and December 2012. Clinicopathological features of patients with IM–SC LN recurrence and patients with DM were retrospectively reviewed. Results With a median follow-up time 78 (range, 13–125) months after the primary operation, 14 (0.3%) had IM–SC LN recurrence without DM and 274 (6.5%) had DM at the first recurrence among 4237 patients. No statistical differences were found in the baseline characteristics of the primary tumor between the two groups. The 5-year overall survival (OS) rate after recurrence in patients with IM–SC LN recurrence was 51% compared with 27% in patients with DM (P = 0.040). In patients with IM–SC LN recurrence, clinically positive axillary LN at diagnosis and pathologically positive axillary LN at primary surgery were poor prognostic factors for distant disease-free survival (DDFS) (P = 0.004 and 0.007, respectively). Clinical and pathological axillary nodal status at primary surgery was associated with OS (P = 0.011 and 0.001, respectively). Conclusions Patients with IM–SC LN recurrence without DM who had no clinical and pathological axillary LNs involved at primary surgery had a favorable prognosis. A larger validation study is required.

Long-Term Outcomes of Breast Cancer Patients Who Underwent Selective Neck Dissection for Metachronous Isolated Supraclavicular Nodal Metastasis

“…The survival of our miSLNM patients was comparable to that of patients with sSLNM in the literature [ 1 , 9 , 29 ], and there were significant differences in the 5-year DMFS between the SND group and the no SND group (31.1% and 9.7%, respectively) and in the 5-year OS, too (68.9% and 57.7%, respectively). Intensive locoregional therapy (radiotherapy or surgery) seems to be mandatory in multimodal therapy to achieve good local control and prevent subsequent distant metastasis [ 17 , 18 , 23 ]. The curative intent of SND as described in our method should be reinforced by surgical removal of all suspicious nodes in level IV and part of those in level V, not just excision of the gross tumor as was done in most of the other studies [ 11 ].…”

“…Metachronous isolated SLNM (miSLNM) was defined as rN3c if metastatic lymph nodes are in the supraclavicular fossa, a triangle defined by the omohyoid muscle and tendon, the internal jugular vein, and the clavicle and subclavian vein, and lymph nodes outside this triangle are considered to be non-lower cervical nodes staging as M1 [ 12 ]. To the best of our knowledge, only a few papers have discussed metachronous isolated SLNM (miSLNM) [ 13 , 14 , 15 , 16 , 17 , 18 ]. Herein, we report a retrospective review of miSLNM with long-term follow-up to evaluate the role of surgery as a multimodal therapy to improve survival outcomes based on our previous research papers on SLNM [ 19 , 20 ].…”

Evaluation of the Property of Axillary Lymph Nodes and Analysis of Lymph Node Metastasis Factors in Breast Cancer by Ultrasound Elastography

“…The calculation method of the sensitivity of routine US was shown as Equation (1), that of specificity was shown as Equation (2), and that of accuracy was as Equation (3). For UE, the calculation method of the sensitivity, specificity, and accuracy was expressed as Equations ( 4), (5), and (6), respectively. In these equations, PB represented the number of patients with benign pathology, and PM was the number of patients with malignant pathology.…”

“…The metastasis of axillary lymph nodes is an important factor to evaluate the overall survival (OS) and disease-free survival (DFS) of breast cancer patients. It is positive to investigate the property of axillary lymph nodes in breast cancer and the influencing factors of lymph node metastasis, which can provide the clinical reference for the treatment of breast cancer [5]. In addition, knowing whether the patient has axillary lymph node metastasis before surgery has a guiding significance for the selection of surgical methods and formulation of treatment plans [6].…”

Internal mammary lymph node metastasis in breast cancer patients based on anatomical imaging and functional imaging

“…The 5-year OS in patients with IM and/or supraclavicular (IM–SC) LN recurrence without distant metastasis (DM) was 51% compared with 27% in patients with DM recurrence. The rate of IM–SC LN recurrence without DM was 0.3%, and with DM was 6.5% at the first recurrence [ 65 ]. Median OS for patients with IMN recurrences as a first event was 2.5 years, with 5 year OS 28% [ 66 ].…”