Prospective multicenter study of combined treatment with chemotherapy and radiotherapy in breast cancer women with the rare clinical scenario of ipsilateral supraclavicular node recurrence without distant metastases

Outcome After Conservative Surgery and Breast Irradiation in 5,717 Patients With Breast Cancer: Implications for Supraclavicular Nodal Irradiation

“…In the patient group analyzed in our study, as in others (26)(27)(28), SFR is uncommon (5.5% in our series of patients with more than three PAN). The main issue regarding survival for patients with more than three PAN is the high occurrence of DM; only 2.2% of these patients could probably receive benefits from RT to the supraclavicular fossa, as suggested by current guidelines (29)(30)(31)(32).…”

Management of locoregional recurrence of breast cancer

“…The clinical complete response rate for radiotherapy with or without chemotherapy ranged from 85 to 94%, the median time to progression was 28 months, and the 5-year overall survival rate after recurrence ranged from 21 to 35% [34,46,50]. Pergolizzi [51] compared 18 patients who received six-cycle chemotherapy alone with 19 patients who received initial three-cycle chemotherapy followed by involved-field radiotherapy and demonstrated that the local control of the former patients was worse than that of the latter patients (13 patients vs. 18 patients) and that the 5-year disease-free survival rate of the former was worse than that of the latter (5.5 vs. 21%, p = 0.01).…”

“…Radiation therapy is an effective local therapy for obtaining local control and avoiding distressing symptoms. Doses of 30-50 Gy are applied in 10-25 fractions over 2-5 weeks, and pain relief and the eradication of other distressing symptoms were achieved in more than two-thirds of patients [46,50,52]. Doses of 40 Gy or more were better at improving the distressing symptoms caused by supraclavicular lymph node metastases than those of less than 40 Gy (92 vs. 55%) [52].…”

Supraclavicular failure after breast-conserving therapy in patients with four or more positive axillary lymph nodes when prophylactic supraclavicular irradiation is omitted

“…Pergolizzi et al also reported that the outcomes of patients with isolated supraclavicular metastasis were better than might be historically assumed when defi nitive locoregional treatment and systemic therapy were administered. 17 In our series, isolated supraclavicular metastasis was not the common failure pattern in patients who had undergone breast-conserving surgery and had had four or more PALNs. Based on the results of our study, a survival benefi t of prophylactic supraclavicular irradiation during BCT seemed small for patients with four or more PALNs.…”