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

Authors
 Jae Sik Kim  ;  Kyubo Kim  ;  Kyung Hwan Shin  ;  Jin Ho Kim  ;  Seung Do Ahn  ;  Su Ssan Kim  ;  Yong Bae Kim  ;  Jee Suk Chang  ;  Doo Ho Choi  ;  Won Park  ;  Tae Hyun Kim  ;  Mison Chun  ;  Jihye Cha  ;  Jin Hee Kim  ;  Dong Soo Lee  ;  Sun Young Lee  ;  Hae Jin Park 
Citation
 JOURNAL OF BREAST CANCER, Vol.23(2) : 194-204, 2020-04 
Journal Title
 JOURNAL OF BREAST CANCER 
ISSN
 1738-6756 
Issue Date
2020-04
Keywords
Breast ; Carcinoma ; Neoplasm metastasis ; Neoplasm staging ; Survival
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.
Files in This Item:
T202004293.pdf Download
DOI
10.4048/jbc.2020.23.e14
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180194
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