박혜진
2020-09-14T01:51:09Z
2020-09-14T01:51:09Z
2019-09
CLINICAL BREAST CANCER, v. 20, no. 1, Page. 51-60
1526-8209
1938-0666
https://www.sciencedirect.com/science/article/pii/S1526820919306846?via%3Dihub
https://repository.hanyang.ac.kr/handle/20.500.11754/153852
With the development of imaging technologies, supraclavicular (SCN) and/or internal mammary nodes are increasingly detected in locally advanced breast cancers. The impact of aggressive treatment such as SCN excision was investigated via a large-scale multicenter study. When breast surgery, systemic therapy, and adjuvant radiotherapy were given, SCN excision did not improve locoregional control or survival.
Introduction: The purpose of this study was to evaluate the outcomes of upfront surgery followed by radiation therapy (RT) for ipsilateral supraclavicular (SCN) and/or internal mammary (IMN) node-positive breast cancer. Materials and Methods: One hundred fifty-eight patients were included; among these, 91 patients were SCN-positive, 54 were IMN-positive, and 13 were SCN- and IMN-positive. Patients underwent breast conserving surgery (n = 74) or mastectomy (n = 84) followed by systemic therapy, and adjuvant RT to whole breast/chest wall with or without regional nodal RT. Regarding regional treatments for SCN and IMN, SCN excision was performed in 59 (37.3%) patients, IMN excision in 10 (6.3%) patients, SCN RT in 143 (90.5%) patients, and IMN RT in 68 (43.0%) patients. Results: The median duration of follow-up was 72 months (range, 7-182 months). There were 20 locoregional recurrences and 45 distant metastases. In-field failure was observed only in SCN (n = 8), and 6 of these patients initially underwent SCN excision. The 5-year locoregional recurrence-free survival, disease-free survival (DFS), and overall survival rates were 87.3%, 71.6%, and 89.7%, respectively. Neither SCN excision nor SCN RT dose >= 54 Gy improved locoregional control (P = .927 and P = .693, respectively) or DFS (P = .394 and P = .686, respectively). Having >= 10 involved axillary lymph nodes was the only independent prognosticator for DFS after adjusting for covariates (P = .003). Conclusion: Regional control rate in initially involved SCN and/or IMN was acceptable in patients treated with upfront surgery followed by systemic therapy plus adjuvant RT. More aggressive regional therapy such as SCN excision did not improve locoregional control or survival.
en
CIG MEDIA GROUP
Internal mammary node
Non-axillary regional lymph node
Prognostic factors
Radiation therapy
Upfront surgery
Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)
Article
epub
epub
10.1016/j.clbc.2019.09.004
1-10
CLINICAL BREAST CANCER
Kim, Kyubo
Kim, Su Ssan
Shin, Kyung Hwan
Kim, Jin Ho
Ahn, Seung Do
Choi, Doo Ho
Park, Won
Lee, Sun Young
Chun, Mison
Park, Hae Jin
2019043975
S
COLLEGE OF MEDICINE[S]
DEPARTMENT OF MEDICINE
haejinpark
https://orcid.org/0000-0003-3891-8952