The significance of supraclavicular fossa node recurrence after radical mastectomy

Fentiman, Ian S.; Lavelle, Michael; Caplan, David; Miller, Naomi; Millis, Rosemary R.; Hayward, John

doi:10.1002/1097-0142(19860301)57:5<908::aid-cncr2820570504>3.0.co;2-q

Cited by 36 publications

(24 citation statements)

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“…Supraclavicular lymph node recurrence (SCLR) in breast cancer is usually considered an unfavorable sign of subsequent distant metastasis (Fentiman et al, 1986;Kiricuta et al, 1994;Harris et al, 2003). A variety of treatments are used for SCLR including surgical resection, radiotherapy (RT), and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Factors for Supraclavicular Lymph Node Recurrence in N1 Breast Cancer Patients

Kong

Hong

2013

Asian Pacific Journal of Cancer Prevention

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Background: The purpose of this study was to identify predictive factors for supraclavicular lymph node recurrence (SCLR) in N1 breast cancer patients and define a high-risk subgroup who might benefit from supraclavicular nodal radiotherapy (RT). Materials and Methods: From January 1995 to December 2009, 113 breast cancer patients with 1 to 3 positive axillary lymph nodes were enrolled in this study. All patients underwent breast-conserving surgery (BCS) or modified radical mastectomy (MRM). RT was given to all patients who received BCS. Among the patients given MRM, those with breast tumors >5 cm in size received RT. Regional nodal irradiation was not applied. Systemic chemotherapy was given to 105 patients (92.9%). Patient data were retrospectively reviewed and analyzed to identify predictive factors for SCLR. Results: The median follow-up duration was 6.5 years, with 5-and 10-year actuarial SCLR rates of 9.3% and 11.2%, respectively. Factors associated with SCLR on univariate analysis included histologic grade, number of dissected axillary lymph nodes, lymphovascular invasion, extracapsular extension (ECE), and adjuvant chemotherapy. On multivariate analysis, histologic grade and ECE remained significant. The patient group with grade 3 and ECE had a significantly higher rate of SCLR compared with the remainder (5-year SCLR rate; 71.4% vs. 4.0%, p<0.001). Conclusions: Histologic grade and ECE status are significant predictive factors for SCLR. Supraclavicular nodal RT is necessary in N1 breast cancer patients featuring histologic grade 3 and ECE.

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Section: Introductionmentioning

confidence: 99%

“…A variety of treatments are used for SCLR including surgical resection, radiotherapy (RT), and chemotherapy. However, despite these treatments, SCLR usually results in significantly reduced survival (Fentiman et al, 1986;McKinna et al, 1999;Harris et al, 2003), and prevention of SCLR is therefore very important.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors for Supraclavicular Lymph Node Recurrence in N1 Breast Cancer Patients

Kong

Hong

2013

Asian Pacific Journal of Cancer Prevention

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“…1- 8 The 5-year survival rate reported in retrospective studies ranges from 4% to 36%. 2,4,7,9 To our knowledge, few studies published to date have considered the role of adjuvant systemic treatment in patients with recurrent breast carcinoma who have been rendered Stage IV-NED with surgery and/or radiotherapy.…”

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confidence: 99%

Combined‐modality treatment for isolated recurrences of breast carcinoma

Hanrahan

Broglio

Buzdar

et al. 2005

Cancer

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BACKGROUNDIn three prospective, single‐arm studies, the authors previously showed an improved outcome for anthracycline‐naïve patients with isolated sites of recurrent breast carcinoma (BC) who were treated with doxorubicin‐based chemotherapy after local therapy (surgery and/or radiotherapy). In the current report, the initial results are presented from a Phase II trial of docetaxel (100 mg/m2 every 21 days for 6 cycles) given after local therapy for recurrent BC (Stage IV BC with no evidence of clinically measurable disease) in patients who received prior adjuvant anthracycline‐based chemotherapy, and the authors provide an update of the 3 previous studies. An analysis of prognostic factors for these patients also is presented.METHODSEligibility criteria for all studies included histologic proof of recurrent BC that had been resected and/or irradiated with curative intent. Survival was calculated using the Kaplan–Meier method. Univariate survival analyses were performed to test for associations between patient characteristics and outcome (log‐rank test). Cox proportional hazards models were used to determine the multivariable correlations between patient characteristics and outcome.RESULTSThe median follow‐up for the docetaxel‐based trial (n = 26 patients) was 45 months. Early outcomes for this study are promising. The median disease‐free survival (DFS) was 44 months, and the 3‐year DFS and overall survival (OS) rates were 58% and 87%, respectively. In the 3 doxorubicin‐based studies, the median follow‐up was 121.5 months for all living patients, and the estimated 20‐year DFS and OS rates were both 26%. On multivariable analysis of patients from all 4 studies, the only significant prognostic factor for DFS and OS (P = 0.0006) was the number of involved axillary lymph nodes at initial diagnosis.CONCLUSIONSA proportion of patients with isolated BC recurrences achieved prolonged DFS with combined‐modality treatment. Patients who receive anthracycline‐based chemotherapy at primary diagnosis may benefit from local treatment followed by docetaxel‐based chemotherapy for isolated recurrences. The only significant independent prognostic factor was the number of involved axillary lymph nodes at initial diagnosis. Cancer 2005. © 2005 American Cancer Society.

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“…The prognosis is worse for these patients than after recurrence in either soft tissue (Fentiman et al, 1986) or bone (Coleman & Rubens, 1987 Group, 1986). The administration of chemotherapy may be complicated by the liver's role in both cytotoxic drug activation, as for cyclophosphamide (Bagley et al, 1973), and metabolism, as with doxorubicin (Benjamin et al, 1974).…”

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confidence: 99%

“…The prognosis is worse for these patients than after recurrence in either soft tissue (Fentiman et al, 1986) or bone (Coleman & Rubens, 1987). Survival is particularly poor in patients with liver metastases and abnormal liver biochemistry (Swenerton et al, 1979;Zinser et al, 1987;S.M. O'Reilly, in preparation).…”

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Weekly epirubicin for breast cancer with liver metastases and abnormal liver biochemistry

Twelves

O'Reilly²,

Coleman³

et al. 1989

Br J Cancer

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Summary Thirty-six consecutive patients with breast cancer and liver metastases with abnormal liver biochemistry were treated with epirubicin 25 mg m-2 i.v. weekly. No dose modification was made for abnormal liver biochemistry, but dose intensity was adjusted by delaying treatment according to myelosuppression. The UICC overall response rate according to UICC criteria was 11/36 (30%) and median response duration was 27 weeks. Liver biochemistry improved in a further seven patients. Treatment was well tolerated. Epirubicin given in this way is effective in patients with breast cancer and liver metastases. An initial deterioration in liver biochemistry may occur before there is a response to epirubicin.Liver metastases are common in patients with advanced breast cancer. The prognosis is worse for these patients than after recurrence in either soft tissue (Fentiman et al., 1986) or bone (Coleman & Rubens, 1987 Group, 1986). The administration of chemotherapy may be complicated by the liver's role in both cytotoxic drug activation, as for cyclophosphamide (Bagley et al., 1973), and metabolism, as with doxorubicin (Benjamin et al., 1974). Moreover, although anthracyclines are the most active single agents in patients with breast cancer (Steiner et al., 1983), toxicity can be severe in patients with impaired liver function and reduced hepatic drug clearance (Benjamin et al., 1974).Epirubicin (4'-epidoxorubicin) is a new anthracycline, structurally related to doxorubicin and with similar activity in patients with advanced breast cancer (Brambilla et al., 1986). It is eliminated more rapidly than doxorubicin (Camaggi et al., 1988) and, at equimolar doses, is less toxic than doxorubicin (Brambilla et al., 1986). We report our experience of the efficacy and toxicity of epirubicin in patients with breast cancer and liver metastases who have abnormal liver biochemistry.Patients received a low dose of epirubicin on a weekly schedule, with the aim of giving a high dose intensity whilst minimising toxicity. Patients and methodsThirty-six patients with histologically proven breast cancer, progressive liver metastases and abnormal liver biochemistry were entered into this phase II study.

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The significance of supraclavicular fossa node recurrence after radical mastectomy

Cited by 36 publications

References 4 publications

Predictive Factors for Supraclavicular Lymph Node Recurrence in N1 Breast Cancer Patients

Predictive Factors for Supraclavicular Lymph Node Recurrence in N1 Breast Cancer Patients

Combined‐modality treatment for isolated recurrences of breast carcinoma

Weekly epirubicin for breast cancer with liver metastases and abnormal liver biochemistry

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