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

• Published in: BMC cancer Vol. 20; no. 1; p. 932
• Main Authors: Inari, Hitoshi, Teruya, Natsuki, Kishi, Miki, Horii, Rie, Akiyama, Futoshi, Takahashi, Shunji, Ito, Yoshinori, Ueno, Takayuki, Iwase, Takuji, Ohno, Shinji
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.09.2020; BioMed Central; BMC
• Subjects: Adult; Aged; Breast - diagnostic imaging; Breast - pathology; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Cancer metastasis; Cancer patients; Cancer therapies; Care and treatment; Cellular biology; Clavicle; Disease-Free Survival; Female; Gene amplification; Humans; Internal mammary lymph node recurrence; Lymph nodes; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic system; Mammary Glands, Human - diagnostic imaging; Mammary Glands, Human - pathology; Mammography; Medical prognosis; Metastases; Metastasis; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - pathology; Patients; Prognosis; Radiation therapy; Statistical analysis; Supraclavicular lymph node recurrence; Surgery; Survival; Ultrasonic imaging; Breast cancer; Prognosis; Supraclavicular lymph node recurrence; Internal mammary lymph node recurrence
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-020-07442-8

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 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. With 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). Patients 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.