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KMID : 1134120200230020194
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Journal of Breast Cancer
2020 Volume.23 No. 2 p.194 ~ p.204
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Cervical Lymph Node Involvement above the Supraclavicular Fossa in Breast Cancer: Comparison with Stage IIIC (KROG 18-02)
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Kim Jae-Sik
Kim Kyu-Bo
Shin Kyung-Hwan
Kim Jin-Ho
Ahn Seung-Do
Kim Su-Ssan
Kim Yong-Bae
Chang Jee-Suk
Choi Doo-Ho
Park Won
Kim Tae-Hyun
Chun Mi-Son
Cha Ji-Hye
Kim Jin-Hee
Lee Dong-Soo
Lee Sun-Young
Park Hae-Jin
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Abstract
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Purpose: We aimed to analyze the treatment outcomes of ipsilateral cervical lymph node (CLN)-positive breast cancer without other distant metastasis and compare the outcomes with those of supraclavicular lymph node (SCL)-positive breast cancer.
Methods: Seventy-eight patients with breast cancer and ipsilateral CLN metastasis above the supraclavicular fossa (CLN[+] group) were treated at 7 institutions (2000?2014). Seventy-four patients received systemic chemotherapy and breast surgery followed by locoregional radiotherapy. Outcomes of the CLN(+) group were compared with those of the SCL(+) group, which included 183 patients with SCL involvement.
Results: The median follow-up duration was 55.9 months. Twenty-two regional failures were found in 15 patients?axillary lymph node (LN) in 8, SCL in 6, internal mammary LN in 3, previously involved CLN in 4, and previously uninvolved ipsilateral CLN in one patient. The 5-year overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates were 68.6%, 46.7%, 68.4%, and 57.0%, respectively. Neck dissection did not improve LRRFS and DFS (p = 0.86 and p = 0.26, respectively). Multivariate analysis showed that hormone receptor negativity and the presence of extracapsular extension were prognostic factors for poor DFS. On comparison with stage IIIC using propensity score matching, survival outcomes of the CLN(+) and SCL(+) groups were not different (5-year OS, p = 0.75; DFS, p = 0.88; LRRFS, p = 0.86; and DMFS, p = 0.45).
Conclusion: The comparable clinical outcomes indicate that patients with breast cancer who have ipsilateral CLN metastasis without other distant metastasis may benefit from locoregional treatment of the ipsilateral breast and systemic therapies, as do those with N3c disease.
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KEYWORD
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Breast, Carcinoma, Neoplasm metastasis, Survival, Neoplasm staging
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