title: Treatment outcome in breast cancer patients with ipsilateral supraclavicular lymph node metastasis at time of diagnosis: a review of the literature.
abstract: BACKGROUND
  In the revised 6th edition of the AJCC-TNM staging system for breast cancer, metastasis in ipsilateral supraclavicular lymph node(s) is considered as a locoregional disease and classified as N3c rather than M1 distant disease. The aim of this review was to search the recent literature in order to investigate whether the reported treatment outcome of patients with ipsilateral supraclavicular metastases in breast cancer patients justifies this revision.
  
  
  METHODS
  A review of the recent English-language literature (January 2001-June 2012) concerning breast cancer with supraclavicular involvement was performed.
  
  
  RESULTS
  A total number of six studies were included in the current review. All reported comparable data with regard to treatment outcome after multimodality treatment, despite considerable heterogeneity in study populations. Patients with ipsilateral supraclavicular lymph node involvement showed outcomes more similar to locally advanced breast cancer patients rather than patients with distant tumor spread.
  
  
  CONCLUSIONS
  It seems that the 2002 revision of the AJCC-TNM staging system for breast cancer has appropriately reclassified patients with supraclavicular disease to a new category (N3c).
authors.affiliation: Sint Franciscus Gasthuis, Department of Surgery, PO Box 10900, 3004 BA Rotterdam, The Netherlands. b.grotenhuis@sfg.nl
authors.forename: B A
authors.initials: BA
authors.lastname: Grotenhuis
authors.forename: T M A L
authors.initials: TM
authors.lastname: Klem
authors.forename: W W
authors.initials: WW
authors.lastname: Vrijland
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D002968:Clavicle; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D016896:Treatment Outcome