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Clin Breast Cancer. 2014 Feb;14(1):53-60. doi: 10.1016/j.clbc.2013.09.008. Epub 2013 Sep 27.

Outcomes of patients with breast cancer who present with ipsilateral supraclavicular or internal mammary lymph node metastases.

Author information

1
Division of Medical Senology, European Institute of Oncology, Milan, Italy. Electronic address: silvia.dellapasqua@ieo.it.
2
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy.
3
Division of Medical Senology, European Institute of Oncology, Milan, Italy.
4
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
5
Division of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, Italy.
6
Integrated Breast Surgery Unit, European Institute of Oncology and University of Milan, Italy.
7
Division of Senology, European Institute of Oncology, Milan, Italy.
8
Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.
9
Department of Medicine, European Institute of Oncology, Milan, Italy.

Abstract

BACKGROUND:

The prognostic implications of internal mammary (IM) and supraclavicular (SC) node involvement in locally advanced breast cancer is still unclear.

PATIENTS AND METHODS:

We evaluated 107 patients with IM (n = 65) or SC (n = 42) node involvement who underwent operation at the European Institute of Oncology between 1997 and 2009 to assess their prognostic features. We subsequently analyzed matched cohorts, using the 107 patients as cases and another group of patients as a control cohort, to evaluate prognostic differences between patients with and those without IM or SC node involvement.

RESULTS:

Five-year disease-free survival (DFS) was 84% in IM vs. 38.8% in SC node involvement (P < .0001), and 5-year overall survival (OS) was 96.9% in IM node vs. 57.1% in SC node involvement (P < .0001). No difference in outcome was found between patients with and controls without IM node involvement. Conversely, a statistically significant difference in DFS and locoregional recurrence was observed in patients with SC node involvement compared with controls without SC node involvement.

CONCLUSION:

SC node involvement correlated with a significantly poorer outcome in patients with locally advanced breast cancer. Adequate staging, including biopsy of suspicious locoregional ipsilateral lymph nodes, is mandatory in these patients. Patients with IM or SC node involvement should be treated with curative intent using combined-modality treatments.

KEYWORDS:

Breast cancer; Internal mammary chain; Supraclavicular lymph nodes

PMID:
24183613
DOI:
10.1016/j.clbc.2013.09.008
[Indexed for MEDLINE]
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