Supraclavicular recurrence after early breast cancer: a curable condition?
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.
Pedersen
Anders N
AN
Department of Oncology, Rigshospitalet, Copenhagen, Denmark. anders.navrsted.pedersen@rh.regionh.dk
Møller
Susanne
S
Steffensen
Karina D
KD
Haahr
Vera
V
Jensen
Merete
M
Kempel
Mette M
MM
Jepsen
Søren L
SL
Madsen
Ebbe L
EL
Roslind
Anne
A
Sandberg
Erik
E
Schöllkopf
Claudia
C
Sørensen
Peter G
PG
Windfeldt
Karen Margrethe
KM
Andersson
Michael
M
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D003718:Denmark; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D016016:Proportional Hazards Models; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome