Top

Published in:

01-02-2011 | Epidemiology

Supraclavicular recurrence after early breast cancer: a curable condition?

Authors: Anders N. Pedersen, Susanne Møller, Karina D. Steffensen, Vera Haahr, Merete Jensen, Mette M. Kempel, Søren L. Jepsen, Ebbe L. Madsen, Anne Roslind, Erik Sandberg, Claudia Schöllkopf, Peter G. Sørensen, Karen Margrethe Windfeldt, Michael Andersson

Published in: Breast Cancer Research and Treatment | Issue 3/2011

Abstract

The prognosis of ipsilateral supraclavicular lymph node recurrence after early breast cancer appears to be worse than for other loco-regional recurrences, but better than for distant metastases. The purpose of the present study was to investigate the relationship between different types of salvage treatment and primary patient characteristics, treatment response, and survival after supraclavicular recurrence (SR) in a large patient population. From the Danish Breast Cancer Cooperative Group treatment database 1977–2003, 305 patients were identified with SR without distant disease as site of first recurrence. Salvage treatment types as well as other factors were related to response and survival. The median follow-up time for progression after SR was 25 months. Complete remission was 76% among patients receiving excision surgery, 67% with combined loco-regional and systemic therapy, and 48% with systemic therapy alone. Median progression-free survival (PFS) and overall survival was 18 and 29 months, respectively. The 5-year PFS probability was 15%. In univariate analysis, combination salvage therapy, negative nodal status and low malignancy grade were related to longer PFS. In multivariate analysis, salvage therapy and malignancy grade remained independent factors for survival. In conclusion, the prognosis of SR is generally poor. However, it appears to be a curable condition. An independent marker of improved outcome is local and systemic combination salvage treatment, which can be considered.

Nielsen HM, Overgaard M, Grau C et al (2006) Loco-regional recurrence after mastectomy in high-risk breast cancer-risk and prognosis. An analysis of patients from the DBCG 82 b&c randomization trials. Radiother Oncol 79:147–155CrossRefPubMed

Chen SC, Chang HK, Lin YC et al (2006) Prognosis of breast cancer after supraclavicular lymph node metastasis: not a distant metastasis. Ann Surg Oncol 13:1457–1465CrossRefPubMed

Pergolizzi S, Settineri N, Santacaterina A et al (2001) Ipsilateral supraclavicular lymph nodes metastases from breast cancer as only site of disseminated disease. Chemotherapy alone vs. induction chemotherapy to radical radiation therapy. Ann Oncol 12:1091–1095CrossRefPubMed

van der Sangen MJ, Coebergh JW, Roumen RM et al (2003) Detection, treatment, and outcome of isolated supraclavicular recurrence in 42 patients with invasive breast carcinoma. Cancer 98:11–17CrossRefPubMed

Ampil FL, Caldito G, Li BD, Burton GV (2003) Supraclavicular nodal relapse of breast cancer: prevalence, palliation, and prognosis. Eur J Gynaecol Oncol 24:233–235PubMed

Moller S, Jensen MB, Ejlertsen B et al (2008) The clinical database and the treatment guidelines of the Danish Breast Cancer Cooperative Group (DBCG); its 30-years experience and future promise. Acta Oncol 47:506–524CrossRefPubMed

Chen SC, Chen MF, Hwang TL et al (2002) Prediction of supraclavicular lymph node metastasis in breast carcinoma. Int J Radiat Oncol Biol Phys 52:614–619CrossRefPubMed

Recht A, Gray R, Davidson NE et al (1999) Locoregional failure 10 years after mastectomy and adjuvant chemotherapy with or without tamoxifen without irradiation: experience of the Eastern Cooperative Oncology Group. J Clin Oncol 17:1689–1700PubMed

Livi L, Scotti V, Saieva C et al (2010) Outcome after conservative surgery and breast irradiation in 5,717 patients with breast cancer: implications for supraclavicular nodal irradiation. Int J Radiat Oncol Biol Phys 76:978–983CrossRefPubMed

10.

Cheng JC, Cheng SH, Lin KJ et al (1998) Diagnostic thoracic-computed tomography in radiotherapy for loco-regional recurrent breast carcinoma. Int J Radiat Oncol Biol Phys 41:607–613CrossRefPubMed

11.

Waeber M, Castiglione-Gertsch M, Dietrich D et al (2003) Adjuvant therapy after excision and radiation of isolated postmastectomy locoregional breast cancer recurrence: definitive results of a phase III randomized trial (SAKK 23/82) comparing tamoxifen with observation. Ann Oncol 14:1215–1221CrossRefPubMed

12.

Haylock BJ, Coppin CM, Jackson J et al (2000) Locoregional first recurrence after mastectomy: prospective cohort studies with and without immediate chemotherapy. Int J Radiat Oncol Biol Phys 46:355–362CrossRefPubMed

13.

Fodor J, Toth J, Major T et al (1999) Incidence and time of occurrence of regional recurrence in stage I–II breast cancer: value of adjuvant irradiation. Int J Radiat Oncol Biol Phys 44:281–287CrossRefPubMed

14.

Halverson KJ, Perez CA, Kuske RR et al (1992) Survival following locoregional recurrence of breast cancer: univariate and multivariate analysis. Int J Radiat Oncol Biol Phys 23:285–291CrossRefPubMed

15.

Kiricuta IC, Willner J, Kolbl O, Bohndorf W (1994) The prognostic significance of the supraclavicular lymph node metastases in breast cancer patients. Int J Radiat Oncol Biol Phys 28:387–393CrossRefPubMed

16.

Abraham R, Nagy T, Goss PE, Crump M (2000) High dose chemotherapy and autologous blood stem cell support in women with breast carcinoma and isolated supraclavicular lymph node metastases. Cancer 88:790–795CrossRefPubMed

17.

Clemons M, Hamilton T, Mansi J et al (2003) Management of recurrent locoregional breast cancer: oncologist survey. Breast 12:328–337CrossRefPubMed

18.

Singletary SE, Allred C, Ashley P et al (2002) Revision of the American Joint Committee on Cancer staging system for breast cancer. J Clin Oncol 20:3628–3636CrossRefPubMed

19.

Pergolizzi S, Adamo V, Russi E et al (2006) Prospective multicenter study of combined treatment with chemotherapy and radiotherapy in breast cancer women with the rare clinical scenario of ipsilateral supraclavicular node recurrence without distant metastases. Int J Radiat Oncol Biol Phys 65:25–32CrossRefPubMed

Title: Supraclavicular recurrence after early breast cancer: a curable condition?
Authors: Anders N. Pedersen
Susanne Møller
Karina D. Steffensen
Vera Haahr
Merete Jensen
Mette M. Kempel
Søren L. Jepsen
Ebbe L. Madsen
Anne Roslind
Erik Sandberg
Claudia Schöllkopf
Peter G. Sørensen
Karen Margrethe Windfeldt
Michael Andersson
Publication date: 01-02-2011
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2011
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-010-0918-8

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2011

Randomized phase III trial of adjuvant epirubicin followed by cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) versus CMF followed by epirubicin in patients with node-negative or 1–3 node-positive rapidly proliferating breast cancer

COX2 expression in prognosis and in prediction to endocrine therapy in early breast cancer patients

Different gene expressions are associated with the different molecular subtypes of inflammatory breast cancer

Inhibition of focal adhesion kinase suppresses the adverse phenotype of endocrine-resistant breast cancer cells and improves endocrine response in endocrine-sensitive cells

Ep-CAM RNA expression predicts metastasis-free survival in three cohorts of untreated node-negative breast cancer

Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study

Keynote webinar | Spotlight on antibody–drug conjugates in cancer