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Prognostic significance of nodal involvement region in clinical stage IIIc breast cancer patients who received primary systemic treatment, surgery, and radiotherapy

 Jae Myoung Noh  ;  Kyung Hwan Kim  ;  Won Park  ;  Chang Ok Suh  ;  Seung Jae Huh  ;  Doo Ho Choi  ;  Ki Chang Keum  ;  Yong Bae Kim 
 BREAST, Vol.24(5) : 637-641, 2015 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Breast Neoplasms/pathology* ; Breast Neoplasms/therapy* ; Carcinoma, Ductal, Breast/secondary* ; Carcinoma, Ductal, Breast/therapy* ; Chemotherapy, Adjuvant ; Clavicle ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Disease-Free Survival ; Dose Fractionation ; Doxorubicin/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision* ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Mammary Glands, Human ; Mastectomy ; Middle Aged ; Neoplasm Recurrence, Local/pathology* ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Survival Rate ; Taxoids/administration & dosage
Breast cancer ; Internal mammary lymph nodes ; Neoadjuvant chemotherapy ; Radiotherapy ; Supraclavicular lymph nodes
OBJECTIVES: To evaluate the prognostic influence of involvement of both internal mammary nodes (IMNs) and supraclavicular nodes (SCNs) in clinical stage IIIc breast cancer patients who underwent primary systemic treatment, surgery, and radiotherapy (RT). MATERIALS AND METHODS: Between 2001 and 2009, 110 breast cancer patients with IMN or SCN involvement were treated with primary systemic treatment followed by surgery and RT. The median age was 50 years. Clinical N-stage was cN3b and cN3c in 29 (26.4%) and 81 (73.6%) patients, respectively. Among the 81 patients with cN3c disease, 18 patients had both IMN and SCN involvement. Primary systemic treatment regimen was most commonly doxorubicin plus docetaxel (54.5%) or cyclophosphamide (20.0%). Mastectomy was performed in 71 (64.5%) patients. The RT dose delivered to the chest wall or whole breast was 50-50.4 Gy in 25-28 fractions. IMN and SCN regions were irradiated in 77 (70.0%) and 107 (97.6%) patients, respectively. RESULTS: At a median follow-up of 57.4 months (range, 8.6-149.9 months), 44 patients (40.0%) developed disease recurrence. Among the 18 patients with both IMN and SCN involvement, 12 patients experienced disease recurrence and 11 of them had distant metastases. The 5-year disease-free survival (DFS) and overall survival (OS) of all patients were 60.2% and 75.5%, respectively. Decreased DFS and OS were observed in the 18 patients with both IMN and SCN involvement (5-year rates, 33.3% and 50.0%; P = 0.0051 and 0.0010, respectively). CONCLUSION: Involvement of both IMNs and SCNs was associated with worse survival outcomes in patients with clinical stage IIIc breast cancer.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Suh, Chang Ok(서창옥)
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