Contralateral Axillary Lymph Node Metastases at the Time of Primary Breast Cancer Diagnosis: Curative or Palliative Intent?

Zhou, Chunyan; Richir, Milan C.; Leenders, M.W.H.; Langenhorst, B. L. A. M.; Knol, H.P.; Schreurs, W. H.

doi:10.1155/2013/389013

Cited by 16 publications

(17 citation statements)

References 5 publications

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“…When comparing this data to the patient presented in this case report, it is important to note that in both Morcos et al retrospective paper and Huston’s case series, nearly all patients had metachronous CAM. Zhou et al present a case of synchronous CAM with hormone receptor positive and HER-2 negative characteristics [4] . This suggests that there is a wide variability in histopathological findings with CAM, and that perhaps synchronous vs. metachronous CAM may represent different disease processes and different primary tumor aggressiveness.…”

Section: Discussionmentioning

confidence: 99%

Contralateral axillary lymph node metastasis in second primary Breast cancer: Case report and review of the literature

Gingerich

Kapenhas

Morgani

et al. 2017

International Journal of Surgery Case Reports

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The rare entity of contra-lateral axillary lymph node metastasis(CAM) has been a debatable topic in the realm of breast cancer management for many years. There remains controversy over whether CAM should be considered distant metastasis or locoregional spread. It is also uncertain why or how CAM occurs. In this case report and review of the literature, we present an 81-year-old female with an apparent second primary breast cancer with synchronous CAM. This paper describes a scenario of altered lymphatic drainage which likely lead to CAM. In this situation, we propose that CAM should be treated with curative intent rather than stage IV disease. We also attempted to gain a better understanding of the histopathology and tumor characteristics of tumors associated with CAM. Our patient was treated with curative intent and remains disease free for over 18 months. This supports the theory that patients with distorted lymphatic drainage from prior interventions who have CAM, should be treated as locoregional extension of the disease.

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Section: Discussionmentioning

confidence: 99%

Contralateral axillary lymph node metastasis in second primary Breast cancer: Case report and review of the literature

Gingerich

Kapenhas

Morgani

et al. 2017

International Journal of Surgery Case Reports

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“…In the survey performed by Bisase and Kerawala [25] in the UK in 2016 regarding the treatment of breast carcinoma neck metastases, 61% of the participants considered level V in the neck, as well as level III, as a disease that cannot be cured. In contrast, aggressive treatment with curative intent was proposed for contralateral axillary metastases [26][27][28][29]; also, fewer supraclavicular and neck metastases were detected with more aggressive primary surgical treatment [30]. As the study by Brito et al [31] and our data suggest, treatment of metastases limited only to the neck should be aggressive and include surgical therapy.…”

Section: Discussionmentioning

confidence: 63%

Distribution of Neck Metastases and Survival in Patients with Breast Carcinoma

et al. 2020

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Neck metastases in breast carcinoma are relatively rare and patients show poor survival rates. A controversy exists over whether neck metastases can be treated as distant or loco-regional metastases. The literature concerning the distribution of metastases in the neck is lacking, as well as data about whether metastases in the higher neck regions cause poorer survival than those in the supraclavicular fossa. Methods: Ultrasound investigation with fine-needle biopsy was performed on 41 breast cancer and confirmed neck metastases patients in a 6-year period. We analysed the distribution of neck metastases and patient survival rates using Kaplan-Meier survival curves and Cox regression. Results: The median survival time from the diagnosis of primary disease to that of neck metastases was 21 months. The presence of metastases in sites other than the neck significantly worsened survival, but multiple metastatic sites did not make it significantly worse. The number of nodes and presence of conglomerates did not considerably affect survival. Conclusion: Neck metastases in breast carcinoma can be found not only in the supraclavicular fossa, but elsewhere in the neck as well. Survival of patients with metastases in higher neck regions was shorter, but not very much so. Survival of patients with metastases limited just to the neck was substantially better, therefore early detection and aggressive treatment that could include neck dissection should be considered.

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“…Despite a lack of consensus, patients seek this type of treatment in the hope of being cured [23-28]. …”

Section: Discussionmentioning

confidence: 99%

Management of sentinel node re-mapping in patients who have second or recurrent breast cancer and had previous axillary procedures

et al. 2014

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BackgroundIn patients with recurrent or second primary ipsilateral breast cancer, axillary staging is the key factor in locoregional control and a strong prognostic characteristic. The efficient evaluation of lymphatic drainage of re-sentinel lymph node biopsies (re-SLNBs) has remained a challenge in the management of ipsilateral primary or recurrent breast cancer patients who are clinically lymph node negative. This study explores whether a SLNB for patients with primary or recurrent breast cancer is possible after previous axillary surgery. It evaluates potential reasons for mapping failure that might be associated with patients in this group.MethodsBetween March 2006 and November 2013, 458 patients were subjected to a breast SLNB. A lymphoscintigraphy procedure was performed on 330 patients for sentinel lymph node (SLN) mapping on the day of surgery. Seven patients with either a second primary cancer in the same breast or recurrent breast cancer were described. Two of these seven patients had axillary lymph node dissection (ALND) during previous treatments and five had SLNB. A dual mapping method was used for all patients. Preoperative lymphoscintigraphy was performed four hours before surgery.ResultsSLNs were successfully remapped in six of seven (85.7%) patients, of whom five (71.43%) had previously undergone SLNB and two (28.57%) previous ALND. Localizations of SLNs were ipsilateral axillary in three patients, ipsilateral internal mammary in one patient, and contralateral axillary in two patients. An altered distribution of lymph nodes was discovered in both patients with previous ALND. In one of the two patients, metastases were found in an aberrant lymph drainage basin at the location of a non-ipsilateral axillary node (contralateral axillary SLN). The second previously ALND patient had an internal mammary SLN. In one patient, mapping was unsuccessful and the SLN was not identified.ConclusionsAltered lymphatic drainage incidence increases following breast-conserving surgery for an initial breast cancer, and the location of SLNs becomes unpredictable at the time of a second primary or recurrent ipsilateral breast cancer. This leads to the necessity of using a radionuclide (lymphoscintigraphy) for a successful re-mapping procedure. A re-SLNB is precise and beneficial even though there are few patients. A lymphoscintigraphy can identify SLNs at their new unpredicted location.

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Contralateral Axillary Lymph Node Metastases at the Time of Primary Breast Cancer Diagnosis: Curative or Palliative Intent?

Cited by 16 publications

References 5 publications

Contralateral axillary lymph node metastasis in second primary Breast cancer: Case report and review of the literature

Contralateral axillary lymph node metastasis in second primary Breast cancer: Case report and review of the literature

Distribution of Neck Metastases and Survival in Patients with Breast Carcinoma

Management of sentinel node re-mapping in patients who have second or recurrent breast cancer and had previous axillary procedures

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