title: The status of neck node metastases in breast cancer--loco-regional or distant?
abstract: Metastases to cervical lymph nodes do not exclusively derive from malignancies of the head and neck area. In the literature the region where distant metastases of breast carcinomas to the neck occur is exclusively named "supraclavicular". The system established by head and neck surgeons regarding neck node topography allows interdisciplinary management of patients with cervical lymph node metastases from breast cancer. Twelve patients suffering from breast cancer who presented with cervical masses have been examined. Most lymph node metastases were found in the posterior triangle of the neck and at the caudo-jugular level, but some metastases were even found in the upper jugular levels. The results presented show that neck node metastases of breast cancer are located superiorly to the supraclavicular region in more than 50% of the cases. According to the AJCC Staging System for Breast Cancer metastases located in the supraclavicular fossa are assessed as loco-regional metastases (N3c). Lymph node metastases situated above the supraclavicular region are not mentioned, but should be considered as distant metastases. This important question remains unanswered and deserves clarification in the current classification of the AJCC Staging System for Breast Cancer.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipps University, Deutschhausstrasse 3, D-35037 Marburg, Germany. sesterhenn@hno-marburg.de
authors.forename: A M
authors.initials: AM
authors.lastname: Sesterhenn
authors.forename: U S
authors.initials: US
authors.lastname: Albert
authors.forename: P J
authors.initials: PJ
authors.lastname: Barth
authors.forename: U
authors.initials: U
authors.lastname: Wagner
authors.forename: J A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D005858:Germany; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011859:Radiography; D014463:Ultrasonography