TY - JOUR
T1 - Prognostic significance of nodal involvement region in clinical stage IIIc breast cancer patients who received primary systemic treatment, surgery, and radiotherapy
AU - Noh, Jae Myoung
AU - Kim, Kyung Hwan
AU - Park, Won
AU - Suh, Chang Ok
AU - Huh, Seung Jae
AU - Choi, Doo Ho
AU - Keum, Ki Chang
AU - Kim, Yong Bae
N1 - Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015
Y1 - 2015
N2 - Objectives: To evaluate the prognostic influence of involvement of both internal mammary nodes (IMNs) and supraclavicular nodes (SCNs) in clinical stage IIIc breast cancer patients who underwent primary systemic treatment, surgery, and radiotherapy (RT). Materials and methods: Between 2001 and 2009, 110 breast cancer patients with IMN or SCN involvement were treated with primary systemic treatment followed by surgery and RT. The median age was 50 years. Clinical N-stage was cN3b and cN3c in 29 (26.4%) and 81 (73.6%) patients, respectively. Among the 81 patients with cN3c disease, 18 patients had both IMN and SCN involvement. Primary systemic treatment regimen was most commonly doxorubicin plus docetaxel (54.5%) or cyclophosphamide (20.0%). Mastectomy was performed in 71 (64.5%) patients. The RT dose delivered to the chest wall or whole breast was 50-50.4 Gy in 25-28 fractions. IMN and SCN regions were irradiated in 77 (70.0%) and 107 (97.6%) patients, respectively. Results: At a median follow-up of 57.4 months (range, 8.6-149.9 months), 44 patients (40.0%) developed disease recurrence. Among the 18 patients with both IMN and SCN involvement, 12 patients experienced disease recurrence and 11 of them had distant metastases. The 5-year disease-free survival (DFS) and overall survival (OS) of all patients were 60.2% and 75.5%, respectively. Decreased DFS and OS were observed in the 18 patients with both IMN and SCN involvement (5-year rates, 33.3% and 50.0%; P = 0.0051 and 0.0010, respectively). Conclusion: Involvement of both IMNs and SCNs was associated with worse survival outcomes in patients with clinical stage IIIc breast cancer.
AB - Objectives: To evaluate the prognostic influence of involvement of both internal mammary nodes (IMNs) and supraclavicular nodes (SCNs) in clinical stage IIIc breast cancer patients who underwent primary systemic treatment, surgery, and radiotherapy (RT). Materials and methods: Between 2001 and 2009, 110 breast cancer patients with IMN or SCN involvement were treated with primary systemic treatment followed by surgery and RT. The median age was 50 years. Clinical N-stage was cN3b and cN3c in 29 (26.4%) and 81 (73.6%) patients, respectively. Among the 81 patients with cN3c disease, 18 patients had both IMN and SCN involvement. Primary systemic treatment regimen was most commonly doxorubicin plus docetaxel (54.5%) or cyclophosphamide (20.0%). Mastectomy was performed in 71 (64.5%) patients. The RT dose delivered to the chest wall or whole breast was 50-50.4 Gy in 25-28 fractions. IMN and SCN regions were irradiated in 77 (70.0%) and 107 (97.6%) patients, respectively. Results: At a median follow-up of 57.4 months (range, 8.6-149.9 months), 44 patients (40.0%) developed disease recurrence. Among the 18 patients with both IMN and SCN involvement, 12 patients experienced disease recurrence and 11 of them had distant metastases. The 5-year disease-free survival (DFS) and overall survival (OS) of all patients were 60.2% and 75.5%, respectively. Decreased DFS and OS were observed in the 18 patients with both IMN and SCN involvement (5-year rates, 33.3% and 50.0%; P = 0.0051 and 0.0010, respectively). Conclusion: Involvement of both IMNs and SCNs was associated with worse survival outcomes in patients with clinical stage IIIc breast cancer.
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U2 - 10.1016/j.breast.2015.07.016
DO - 10.1016/j.breast.2015.07.016
M3 - Article
C2 - 26283599
AN - SCOPUS:84952637686
VL - 24
SP - 637
EP - 641
JO - Breast
JF - Breast
SN - 0960-9776
IS - 5
ER -