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Outcome of breast-conserving treatment for axillary lymph node metastasis from occult breast cancer with negative breast MRI

 Haeyoung Kim  ;  Won Park  ;  Su Ssan Kim  ;  Sung Ja Ahn  ;  Yong Bae Kim  ;  Tae Hyun Kim  ;  Jin Hee Kim  ;  Jin-Hwa Choi  ;  Hae Jin Park  ;  Jee Suk Chang  ;  Doo Ho Choi 
 BREAST, Vol.49 : 63-69, 2020-02 
Journal Title
Issue Date
Adenocarcinoma / diagnostic imaging ; Adenocarcinoma / mortality ; Adenocarcinoma / pathology ; Adenocarcinoma / surgery* ; Adult ; Aged ; Axilla ; Breast Neoplasms / diagnostic imaging ; Breast Neoplasms / mortality ; Breast Neoplasms / pathology ; Breast Neoplasms / surgery* ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision* ; Lymphatic Metastasis ; Magnetic Resonance Imaging* ; Mastectomy, Segmental* ; Middle Aged ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Neoplasms ; Unknown primary ; Breast neoplasm ; Lymph nodes ; Magnetic resonance imaging ; Radiotherapy
Purpose: We conducted this study to investigate the prognosis and failure pattern after breast-conserving treatment (BCT) in patients with occult breast cancer (OBC) with negative breast magnetic resonance imaging (MRI) (MRI-OBC). Materials and methods: Survival rates and failure patterns in 66 patients who received axillary lymph node dissection (ALND) and BCT for MRI-OBC between 2001 and 2013 at seven hospitals were analyzed. OBC was defined as adenocarcinoma in the axillary lymph node (ALN) +/- supraclavicular (SCN) or internal mammary lymph node (IMN) with a negative breast MRI. Results: Fifty-four patients had only ALN metastasis (ALN only), and 12 patients had ALN metastasis along with SCN or IMN metastasis (ALN + SCN/IMN). Median follow-up was 82 months. The 5-year overall, disease-free, and breast cancer-free survival rates were 93.4%, 92.1%, and 96.8%, respectively. Nine patients experienced recurrence: breast (n = 4), regional lymph nodes (RLN, n = 1), distant metastases (DM, n = 2), breast/RLN (n = 1), and breast/RLN/DM (n = 1). Five-year disease-free survival was significantly higher in ALN only patients compared to ALN + SCN/IMN patients (96.1% vs. 75.0%; p = 0.02). Conclusions: Patients with MRI-OBC were successfully treated with BCT. There was a small risk of ipsilateral breast cancer recurrence. Failure patterns depended on the extent of initial disease. (C) 2019 Published by Elsevier Ltd.
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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
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