Predictive factors and prognostic value of pathologic complete response of ipsilateral supraclavicular lymph nodes in breast cancer after neoadjuvant chemotherapy

Abstract

Background: Breast cancer with ipsilateral supraclavicular lymph node metastasis is one of the indicators of poor prognosis. Patients who attain pathologic complete response in breast and axillary sites have improved survival and are highest in aggressive HR-HER2-and HER2-positive tumor subtypes. However, there is no study on the related factors and prognostic value of supraclavicular pathologic complete response in breast cancer after neoadjuvant chemotherapy. The aim of our work was to investigate the factors and prognostic significance of pathologic complete response of ipsilateral supraclavicular lymph node metastasis in breast cancer after neoadjuvant chemotherapy.Methods: A total of 214 patients with breast cancer who had primary ISLN metastasis, receiving NAC and subsequent ISLN dissection, were retrospectively and consecutively reviewed. Univariate and multivariate analyses were performed using χ 2 test and the logistic regression model, and the prognosis was analyzed by Kaplan-Meier curve.Results: All patients included were women who were 26-74 years old. The rate of supraclavicular pathologic complete response (pCR) was 53.7%. Multivariate analysis showed that the expression of Ki67, breast pCR, and axillary pCR were independent predictors of supraclavicular pCR (P<0.05). After a median follow-up of 16.2 months, the risk of recurrence and metastasis in patients with supraclavicular pCR was half reduced compared to that of the non-pCR group (HR 0.51, 95% CI, 0.32-0.80, P<0.01), mainly manifested in HR-HER2-and HER2-positive disease. Conclusions:The expression level of Ki67, breast pCR, and axillary pCR were independent predictors of supraclavicular pCR. Supraclavicular pCR was an independent predictor of disease-free survival (DFS). Surgical removal of supraclavicular lymph nodes can accurately evaluate the rate of supraclavicular pCR, which is of great significance for patient prognosis.

<p>Elevated Platelet Count Predicts Poor Prognosis in Breast Cancer Patients with Supraclavicular Lymph Node Metastasis</p>

“…This result was inconsistent with our previous findings that menopausal status was not related to the prognosis of breast cancer patients with ISLN metastasis. 26 We think the reasons were as follows: there were differences in the follow-up time between the two studies. The median follow-up time in this study was 30 months, while the median follow-up time in a previous study was 16.2 months.…”

Modified radical mastectomy for level III axillary lymph node clearance: a case report

“…This nerve is an important anatomical structure of the axilla, closely related to the abnormal sensory function sometimes seen after operation. The intercostobrachial nerve usually originates in the second intercostal space, and often merges with the first and third intercostal nerve branches (12,13). In the present operation, the surgeon carefully dissected and exposed the lateral cutaneous branches of the intercostal nerves and intercostobrachial nerve on the side of the chest wall, freeing them completely, while paying attention to keep the electro tome away from the nerves.…”

The Clinical Importance of Androgen Receptor Status in Response to Neoadjuvant Chemotherapy in Turkish Patients with Local and Locally Advanced Breast Cancer

“…In a trial published in 2018, a total of 668 breast cancer patients who had received NACT were evaluated to assess the prediction effects of AR status on pCR. AR positivity was found in 74.6%, and AR was found to be an independent predictor of pCR [25]. In a study published in 2011, Loibl et al [26] evaluated immunohistochemical AR expression on a tissue microarray of core biopsies from primary breast cancer patients treated with neoadjuvant docetaxel/doxorubicin/cyclophosphamide chemotherapy in the prospective GeparTrio phase-III trial.…”