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Title: Locoregional treatment outcomes for breast cancer patients with ipsilateral supraclavicular metastases at diagnosis

Abstract

Purpose: To evaluate the locoregional efficacy of multimodality treatment for breast cancer patients who present with ipsilateral supraclavicular (SCV) disease without systemic metastases. Methods: We retrospectively reviewed the data from 71 patients with ipsilateral SCV involvement at presentation. SCV involvement in 16 patients (23%) was diagnosed by ultrasound examination only, without palpable disease. All patients were treated with curative intent using neoadjuvant chemotherapy, mastectomy or breast-conserving surgery (BCT), and radiotherapy. Results: The 5-year SCV control, locoregional control (LRC), disease-free survival, and overall survival rate was 90%, 77%, 30%, and 47%, respectively. Patients with persistent SCV disease after neoadjuvant chemotherapy by physical examination had a lower rate of LRC (64% vs. 86%, p = 0.026), as did those with persistent SCV disease by ultrasound examination (66% vs. 96%, p = 0.007). Of those with a complete response of SCV disease by physical examination after neoadjuvant chemotherapy, those with persistently abnormal ultrasound findings had significantly worse disease-free survival (0% vs. 55%, p = 0.03). BCT was not associated with lower rates of LRC (82% for BCT vs. 76% for mastectomy, p = 0.80). Conclusion: Radiotherapy achieved excellent LRC after surgery for patients with ipsilateral SCV metastases who achieved a complete response ofmore » the SCV disease after neoadjuvant chemotherapy. For patients who achieved a complete response of the SCV disease by physical examination, ultrasonography of the SCV fossa may help assess the risk of disease recurrence. SCV involvement should not be considered a contraindication for BCT.« less

Authors:
 [1];  [1];  [2];  [3];  [1];  [1];  [1];  [1];  [1];  [4];  [4];  [5];  [4];  [6];  [7]
  1. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  2. Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  3. Department of Diagnostic Imagining, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  4. Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  5. Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  6. Dept. of Breast Medical Oncology, Univ. of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  7. Dept. of Radiation Oncology, Univ. of Texas M. D. Anderson Cancer Center, Houston, TX (United States). E-mail: tbuchhol@mdanderson.org
Publication Date:
OSTI Identifier:
20944692
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2006.08.040; PII: S0360-3016(06)02815-X; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; DIAGNOSIS; MAMMARY GLANDS; METASTASES; PATIENTS; RADIOTHERAPY; SURGERY; TETRAGONAL LATTICES; ULTRASONOGRAPHY

Citation Formats

Huang, Eugene H., Strom, Eric A., Valero, Vicente, Fornage, Bruno, Perkins, George H., Oh, Julia L., Yu, T.-K., Tereffe, Welela, Woodward, Wendy A., Hunt, Kelly K., Meric-Bernstam, Funda, Sahin, Aysegul A., Bedrosian, Isabelle, Hortobagyi, Gabriel N., and Buchholz, Thomas A. Locoregional treatment outcomes for breast cancer patients with ipsilateral supraclavicular metastases at diagnosis. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.08.040.
Huang, Eugene H., Strom, Eric A., Valero, Vicente, Fornage, Bruno, Perkins, George H., Oh, Julia L., Yu, T.-K., Tereffe, Welela, Woodward, Wendy A., Hunt, Kelly K., Meric-Bernstam, Funda, Sahin, Aysegul A., Bedrosian, Isabelle, Hortobagyi, Gabriel N., & Buchholz, Thomas A. Locoregional treatment outcomes for breast cancer patients with ipsilateral supraclavicular metastases at diagnosis. United States. doi:10.1016/j.ijrobp.2006.08.040.
Huang, Eugene H., Strom, Eric A., Valero, Vicente, Fornage, Bruno, Perkins, George H., Oh, Julia L., Yu, T.-K., Tereffe, Welela, Woodward, Wendy A., Hunt, Kelly K., Meric-Bernstam, Funda, Sahin, Aysegul A., Bedrosian, Isabelle, Hortobagyi, Gabriel N., and Buchholz, Thomas A. Thu . "Locoregional treatment outcomes for breast cancer patients with ipsilateral supraclavicular metastases at diagnosis". United States. doi:10.1016/j.ijrobp.2006.08.040.
@article{osti_20944692,
title = {Locoregional treatment outcomes for breast cancer patients with ipsilateral supraclavicular metastases at diagnosis},
author = {Huang, Eugene H. and Strom, Eric A. and Valero, Vicente and Fornage, Bruno and Perkins, George H. and Oh, Julia L. and Yu, T.-K. and Tereffe, Welela and Woodward, Wendy A. and Hunt, Kelly K. and Meric-Bernstam, Funda and Sahin, Aysegul A. and Bedrosian, Isabelle and Hortobagyi, Gabriel N. and Buchholz, Thomas A.},
abstractNote = {Purpose: To evaluate the locoregional efficacy of multimodality treatment for breast cancer patients who present with ipsilateral supraclavicular (SCV) disease without systemic metastases. Methods: We retrospectively reviewed the data from 71 patients with ipsilateral SCV involvement at presentation. SCV involvement in 16 patients (23%) was diagnosed by ultrasound examination only, without palpable disease. All patients were treated with curative intent using neoadjuvant chemotherapy, mastectomy or breast-conserving surgery (BCT), and radiotherapy. Results: The 5-year SCV control, locoregional control (LRC), disease-free survival, and overall survival rate was 90%, 77%, 30%, and 47%, respectively. Patients with persistent SCV disease after neoadjuvant chemotherapy by physical examination had a lower rate of LRC (64% vs. 86%, p = 0.026), as did those with persistent SCV disease by ultrasound examination (66% vs. 96%, p = 0.007). Of those with a complete response of SCV disease by physical examination after neoadjuvant chemotherapy, those with persistently abnormal ultrasound findings had significantly worse disease-free survival (0% vs. 55%, p = 0.03). BCT was not associated with lower rates of LRC (82% for BCT vs. 76% for mastectomy, p = 0.80). Conclusion: Radiotherapy achieved excellent LRC after surgery for patients with ipsilateral SCV metastases who achieved a complete response of the SCV disease after neoadjuvant chemotherapy. For patients who achieved a complete response of the SCV disease by physical examination, ultrasonography of the SCV fossa may help assess the risk of disease recurrence. SCV involvement should not be considered a contraindication for BCT.},
doi = {10.1016/j.ijrobp.2006.08.040},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 67,
place = {United States},
year = {Thu Feb 01 00:00:00 EST 2007},
month = {Thu Feb 01 00:00:00 EST 2007}
}