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Cervical Lymph Node Involvement above the Supraclavicular Fossa in Breast Cancer: Comparison with Stage IIIC (KROG 18-02)

Title
Cervical Lymph Node Involvement above the Supraclavicular Fossa in Breast Cancer: Comparison with Stage IIIC (KROG 18-02)
Authors
Kim, Jae SikKim, KyuboShin, Kyung HwanKim, Jin HoAhn, Seung DoKim, Su SsanKim, Yong BaeChang, Jee SukChoi, Doo HoPark, WonKim, Tae HyunChun, MisonCha, JihyeKim, Jin HeeLee, Dong SooLee, Sun YoungPark, Hae Jin
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2020
Journal Title
JOURNAL OF BREAST CANCER
ISSN
1738-6756JCR Link

2092-9900JCR Link
Citation
JOURNAL OF BREAST CANCER vol. 23, no. 2, pp. 194 - 204
Keywords
BreastCarcinomaNeoplasm metastasisSurvivalNeoplasm staging
Publisher
KOREAN BREAST CANCER SOC
Indexed
SCIE; SCOPUS; KCI WOS
Document Type
Article
Abstract
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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DOI
10.4048/jbc.2020.23.e14
Appears in Collections:
의과대학 > 의학과 > Journal papers
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