Y. CHO1, Y. Jang1, S. Kim1 1Inha University Hospital,Surgery/Inha University School Of Medicine,Incheon, , South Korea
Introduction: Isolated supraclavicular lymph node metastasis(iSLNM) in breast cancer can be managed with surgery, systemic therapy with/or radiotherapy. We performed this study to analyze the survival and outcome of selective neck node dissection of breast cancer patients with isolated supraclavicular lymph node metastasis.
Methods: A total of 1,602 consecutive women with primary breast cancer who received surgical treatment in the single institute from 2004 to 2013 were included in this study. iSLNM were defined as only isolated supraclavicular neck nodal recurrence without any local/regional or systemic recurrence. All iSLNM had proved with tissue or imaging studies before surgery. Selective neck dissection defined as curative intent to remove all nodes and soft tissue in neck level IV and part of III and V. The clinical and biological features, the overall survival and disease free survival were analyzed for selective neck dissection.
Results: Of the 1,602 patients, five(0.3%) developed iSLNM during the period. All iSLNM patients had pathologic proof of ISLNM without evidence of any other regional or distant spread by imaging studies at the event. All of iSLNM patients had selective neck dissections according to identified lymph node metastasis. Three of iSLNM were noted at ipsilateral neck, and two in contralateral neck. Mean duration of iSLNM from primary surgery for breast cancer was 44.4 months. All iSLNM patients survive in 48, 32, 57, 14 and 10 months after selective neck dissection, two patients developed liver metastasis and one lung metastasis during the period.
Conclusion: The development of iSLNM may be a bad sign for distant metastasis in breast cancer patient. But aggressive surgical treatment should be established on iSLNM.