Treatment Patterns and Outcomes of Women with Breast Cancer and Supraclavicular Nodal Metastases

Tamirisa, Nina; Ren, Yi; Campbell, Brittany M.; Thomas, Samantha M.; Fayanju, Oluwadamilola M.; Plichta, Jennifer K.; Rosenberger, Laura H.; Force, Jeremy; Hyslop, Terry; Hwang, E. Shelley; Greenup, Rachel A.

doi:10.1245/s10434-020-09024-1

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…In our long-term follow-up study of miSLNM, the SND group had a significantly longer time interval from neck metastasis to occurrence of distant metastasis compared to the no SND group (23.7 months and 14.5 months, respectively), and the interval from neck relapse to death was also longer in the SND group (44.7 months and 30.1 months, respectively). 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 ].…”

Section: Discussionsupporting

confidence: 71%

“…Supraclavicular lymph node metastasis (SLNM) of breast cancer is a clinical challenge for most patients presenting with de novo M1 disease, and it has poor outcomes, although its incidence rate was 3.7% to 8% [ 1 , 2 , 3 , 4 ], more prevalent in patients with high disease burden, such as more than four positive axillary nodes, and those with axillary level II or III nodal involvement. A recent clinicopathological study demonstrated the association of lymphovascular invasion with regional lymph node metastasis and systemic metastasis, suggesting that the anastomotic pathway of systemic metastasis from primary breast cancer was through regional lymph nodes [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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

Chen

Shen

et al. 2021

Cancers

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We retrospectively enrolled 139 patients who developed metachronous isolated supraclavicular lymph node metastasis (miSLNM) from 8129 consecutive patients who underwent primary surgery between 1990 and 2008 at a single medical center. The median age was 47 years. The median follow-up time from date of primary tumor surgery was 73.1 months, and the median time to the date of neck relapse was 43.9 months in this study. Sixty-one (43.9%) patients underwent selective neck dissection (SND). The 5-year distant metastasis-free survival (DMFS), post-recurrence survival, and overall survival (OS) rates in the SND group were 31.1%, 40.3%, and 68.9%, respectively, whereas those of the no-SND group were 9.7%, 32.9%, and 57.7%, respectively (p = 0.001). No SND and time interval from primary tumor surgery to neck relapse ≤24 months were the only significant risk factors in the multivariate analysis of DMFS (hazard ratio (HR), 1.77; 95% confidence interval (CI), 1.23–2.56; p = 0.002 and HR, 1.76, 95% CI, 1.23–2.52; p = 0.002, respectively) and OS (HR, 1.77; 95% CI, 1.22–2.55; p = 0.003 and HR, 3.54, 95% CI, 2.44–5.16; p < 0.0001, respectively). Multimodal therapy, including neck dissection, significantly improved the DMFS and OS of miSLNM. Survival improvement after miSLNM control by intensive surgical treatment suggests that miSLNM is not distant metastasis.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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

Chen

Shen

et al. 2021

Cancers

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“…In addition, a high proportion of LNP <14 and LNR <0.8148 were also the characteristics of these patients. Notably, after breast cancer patients with supraclavicular nodal metastases downstaged from AJCC stage IV to IIIC, N3c patients who received the standard therapy demonstrated better OS than stage IV disease [ 17 , 18 ]. Hence, we sought to illustrate whether there was a difference between stage IIIC patients.…”

Section: Discussionmentioning

confidence: 99%

Nontherapeutic Risk Factors of Different Grouped Stage IIIC Breast Cancer Patients’ Mortality: A Study of the US Surveillance, Epidemiology, and End Results Database

et al. 2022

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Objectives. Stage IIIC breast cancer, as a local advanced breast cancer, has a poor prognosis compared with that of early breast cancer. We further investigated the risk factors of mortality in stage IIIC primary breast cancer patients and their predictive value. Methods. We extracted data from the US Surveillance, Epidemiology, and End Results (SEER) database of female patients with stage IIIC primary breast cancer (n = 1673) from January 2011 to December 2015. Results. Hormone receptor negativity ( P ≤ 0.001 and P ≤ 0.001 , respectively), aggressive molecular typing ( P ≤ 0.001 and P ≤ 0.001 , respectively), high T stage ( P ≤ 0.001 and P ≤ 0.001 , respectively), a high number of positive lymph nodes (≥14) ( P = 0.005 and P = 0.001 , respectively), and lymph node ratio (≥0.8148) ( P ≤ 0.001 and P ≤ 0.001 , respectively) were associated with poor disease-specific survival. The indicators of disease-specific survival included estrogen receptor status, progesterone receptor status, molecular typing, T stage, number of positive lymph nodes, and lymph node ratio ( P ≤ 0.001 , P ≤ 0.001 , P ≤ 0.001 , P ≤ 0.001 , P = 0.002 , and P ≤ 0.001 , respectively). Conclusion. Hormone receptor negativity, aggressive molecular typing, high T stage, high number of positive lymph nodes, and lymph node ratio are poor prognostic factors patients with stage IIIC primary breast cancer. The efficient indicators of disease-specific survival include estrogen receptor status, progesterone receptor status, molecular typing, T stage, number of positive lymph nodes, and lymph node ratio.

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“…In a retrospective one-arm evaluation, multimodal treatment, including neoadjuvant chemotherapy, breast surgery, and RT, achieved acceptable local control and survival in patients with internal mammary (25) and S/I lymph node metastasis (26). Furthermore, an evaluation of the National Cancer Database revealed that patients with cN3c breast cancer (supraclavicular lymph node involvement) who received multimodal therapy showed improved OS in comparison to patients who did not receive standard therapy (27). In a phase III study, RT targeting the medial supraclavicular lymph nodes improved 15-year breast cancer mortality and breast cancer recurrence but not OS (28).…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Absolute Lymphocyte Count and Neutrophil-to-lymphocyte Ratio Are Prognostic Factors for Stage III Breast Cancer

et al. 2021

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Background/Aim: Stage III breast cancer comprises a broad spectrum of disease, including the extent of supraclavicular/internal mammary lymph node metastasis. In this study, we evaluated the usefulness of the absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of patients with stage III breast cancer. Patients and Methods: Seventy-five patients with stage III breast cancer who underwent surgery were included. We compared their clinicopathological factors according to the presence or not of supraclavicular/internal mammary lymph node metastasis, and pretreatment ALC or NLR. Results: Patients with metastasis of the studied lymph nodes had a poorer prognosis in comparison to those without metastasis. In patients without these types of lymph node metastasis, both the ALC and NLR were predictive factors for relapse-free and overall survival. Among these patients, those with a low ALC or high NLR had recurrence-free and overall survival comparable to those of patients with supraclavicular/internal mammary lymph node metastasis. Conclusion: Pretreatment ALC and NLR were prognostic factors for patients with stage III breast cancer.

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Treatment Patterns and Outcomes of Women with Breast Cancer and Supraclavicular Nodal Metastases

Cited by 8 publications

References 19 publications

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

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

Nontherapeutic Risk Factors of Different Grouped Stage IIIC Breast Cancer Patients’ Mortality: A Study of the US Surveillance, Epidemiology, and End Results Database

Pretreatment Absolute Lymphocyte Count and Neutrophil-to-lymphocyte Ratio Are Prognostic Factors for Stage III Breast Cancer

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