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Original Article
- Impact of Regional Nodal Irradiation for Breast Cancer Patients with Supraclavicular and/or Internal Mammary Lymph Node Involvement: A Multicenter, Retrospective Study (KROG 16-14)
- Kyubo Kim, Yuri Jeong, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Su Ssan Kim, Chang-Ok Suh, Yong Bae Kim, Doo Ho Choi, Won Park, Jihye Cha, Mison Chun, Dong Soo Lee, Sun Young Lee, Jin Hee Kim, Hae Jin Park, Wonguen Jung
- Cancer Res Treat. 2019;51(4):1500-1508. Published online March 15, 2019
- DOI: https://doi.org/10.4143/crt.2018.575
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Abstract
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Supplementary Material
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ePub - Purpose
The purpose of this study was to evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement.
Materials and Methods
A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjuvant systemic therapy followed by breast-conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.
Results
The median follow-up duration was 61 months (range, 7 to 173 months). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥ 4, triple-negative subtype, and mastectomy were significant adverse prognosticators for DFS (p=0.022, p=0.001, p=0.001, and p=0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥ 54 Gy was not associated with DFS (5-year rate, 52.9% vs. 50.9%; p=0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-year rate, 56.1% vs. 78.1%; p=0.099) in IMN-involved patients.
Conclusion
Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients. -
Citations
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- Clinical outcomes after post-operative radiotherapy for breast cancer patients presenting with ipsilateral supraclavicular metastasis: considerations on the cranial border of irradiation field
Xiaofang Wang, Xiaomeng Zhang, Li Zhang, Jin Meng, Wei Shi, Xingxing Chen, Zhaozhi Yang, Xin Mei, Xiaoli Yu, Zhen Zhang, Zhimin Shao, Xiaomao Guo, Jinli Ma
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Annals of Surgical Oncology.2025; 32(3): 2070. CrossRef - Internal mammary regional management after neoadjuvant therapy in breast cancer
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International Journal of Surgery.2024;[Epub] CrossRef - Oncological outcomes in patients with residual triple-negative breast cancer after preoperative chemotherapy
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International Journal of Radiation Oncology*Biology*Physics.2022; 112(1): 66. CrossRef - Locoregional Management and Prognostic Factors in Breast Cancer With Ipsilateral Internal Mammary and Axillary Lymph Node Involvement
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Journal of Breast Cancer.2020; 23(2): 194. CrossRef - Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)
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Clinical Breast Cancer.2020; 20(1): 51. CrossRef Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement
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Cancer Management and Research.2020; Volume 12: 11857. CrossRef
- Clinical outcomes after post-operative radiotherapy for breast cancer patients presenting with ipsilateral supraclavicular metastasis: considerations on the cranial border of irradiation field
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