Clinicopathological features of breast cancer patients with internal mammary and/or supraclavicular lymph node recurrence without distant metastasis

Hitoshi Inari,Yoshinori Ito,Futoshi Akiyama,Takuji Iwase,Takayuki Ueno,Rie Horii,Shinji Ohno,Miki Kishi,Natsuki Teruya,Shunji Takahashi

doi:10.1186/s12885-020-07442-8

Hitoshi Inari, Yoshinori Ito + Show 8 more

Open Access

https://doi.org/10.1186/s12885-020-07442-8

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Journal: BMC Cancer	Publication Date: Sep 29, 2020
Citations: 4	License type: open-access

Affiliation: Japanese Foundation For Cancer Research

Abstract

BackgroundInternal mammary and/or supraclavicular (IM–SC) lymph node (LN) recurrence without distant metastasis (DM) in patients with breast cancer is rare, and there have been few reports on its clinical outcomes.MethodsWe enrolled 4237 patients with clinical stage I–IIIC breast cancer treated between January 2007 and December 2012. Clinicopathological features of patients with IM–SC LN recurrence and patients with DM were retrospectively reviewed.ResultsWith a median follow-up time 78 (range, 13–125) months after the primary operation, 14 (0.3%) had IM–SC LN recurrence without DM and 274 (6.5%) had DM at the first recurrence among 4237 patients. No statistical differences were found in the baseline characteristics of the primary tumor between the two groups. The 5-year overall survival (OS) rate after recurrence in patients with IM–SC LN recurrence was 51% compared with 27% in patients with DM (P = 0.040). In patients with IM–SC LN recurrence, clinically positive axillary LN at diagnosis and pathologically positive axillary LN at primary surgery were poor prognostic factors for distant disease-free survival (DDFS) (P = 0.004 and 0.007, respectively). Clinical and pathological axillary nodal status at primary surgery was associated with OS (P = 0.011 and 0.001, respectively).ConclusionsPatients with IM–SC LN recurrence without DM who had no clinical and pathological axillary LNs involved at primary surgery had a favorable prognosis. A larger validation study is required.

Highlights

Internal mammary and/or supraclavicular (IM–SC) lymph node (LN) recurrence without distant metastasis (DM) in patients with breast cancer is rare, and there have been few reports on its clinical outcomes
We retrospectively reviewed clinicopathological characteristics, treatment modality, disease-free interval, IM–SC LN recurrence status, and distant disease-free survival (DDFS) and overall survival (OS)
Clinicopathological features of patients with IM–SC LN recurrence without DM and those with DM Among 4237 patients with breast cancer whose background characteristics are shown in Table S1, 14 (0.3%) had IM–SC LN recurrence without DM and 274 (6.5%) had DM (Fig. 1, Table 1)

Summary

Introduction

Internal mammary and/or supraclavicular (IM–SC) lymph node (LN) recurrence without distant metastasis (DM) in patients with breast cancer is rare, and there have been few reports on its clinical outcomes. Patients with internal mammary and/or supraclavicular (IM–SC) LN recurrence are reported to have better clinical outcome than those with DM. Patients with IM–SC LN recurrence have a worse clinical outcome than those with ipsilateral breast tumor recurrence [3,4,5]. IM–SC LN recurrence without DM is rare; conducting a prospective randomized trial to compare different treatment strategies is difficult and few retrospective studies have shown long-term outcomes with IM-SC LN recurrence [3]. The clinical management of IM–SC LN recurrence without DM in patients with breast cancer is generally empirical, especially in terms of whether cure can be aimed at

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