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Title: Long-Term Outcomes in Patients With Isolated Supraclavicular Nodal Recurrence After Mastectomy and Doxorubicin-Based Chemotherapy for Breast Cancer

Abstract

Purpose: To examine the outcome of patients who developed an isolated locoregional recurrence (LRR) involving the supraclavicular fossa (SCV) after initial treatment with modified radical mastectomy and chemotherapy. Methods and Materials: Records from 140 breast cancer patients treated on five prospective trials with mastectomy and doxorubicin-based chemotherapy, with or without radiation, who developed a LRR were reviewed. Kaplan-Meier survival times were calculated using date of LRR as time zero. Results: The median follow-up after LRR was 2.9 years (N = 140; interquartile range, 1.3-6.6 years). In all, 47 of 140 patients (34%) had an SCV component to their LRR. These patients had lower 3-y distant metastasis-free survival (40% vs. 54%, p = 0.003) and overall survival (49% vs. 69%, p = 0.04) than patients without an SCV component. Multivariate analysis revealed that LRR involving an SCV component (hazard ratio, 1.96, p = 0.004) and patients with lymphovascular space invasion in their primary tumors (hazard ratio, 1.65, p = 0.029) were independently associated with a poor distant metastasis-free survival. However, among 23 patients with isolated SCV recurrence, Overall survival was not statistically significantly different between isolated chest wall recurrence and isolated SCV recurrence. Patients with isolated SCV recurrence displayed a medianmore » follow-up of 3.3 years (IR, 1.2-5.2). Only 6 LRR of 23 patients were treated with aggressive local therapy, including surgery, chemotherapy, and radiation (alone or in combination). Conclusions: Although breast cancer recurrence with SCV involvement carries a high risk of distant metastasis and death, among women with recurrence limited to the SCV alone, overall survival after isolated SCV recurrence can be long (25% >5 years).« less

Authors:
 [1]; ; ; ; ;  [2];  [2]
  1. Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX (United States)
  2. Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
21587639
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.04.015; PII: S0360-3016(10)00588-2; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; CHEST; DOXORUBICIN; HAZARDS; MAMMARY GLANDS; METASTASES; MULTIVARIATE ANALYSIS; NEOPLASMS; SURGERY; ANTIBIOTICS; ANTI-INFECTIVE AGENTS; ANTINEOPLASTIC DRUGS; BODY; DISEASES; DRUGS; GLANDS; MATHEMATICS; MEDICINE; ORGANIC COMPOUNDS; ORGANS; STATISTICS; THERAPY

Citation Formats

Reddy, Jay P., Levy, Larry, Oh, Julia L., Strom, Eric A., Perkins, George H., Buchholz, Thomas A., and Woodward, Wendy A., E-mail: wwoodward@mdanderson.org. Long-Term Outcomes in Patients With Isolated Supraclavicular Nodal Recurrence After Mastectomy and Doxorubicin-Based Chemotherapy for Breast Cancer. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.04.015.
Reddy, Jay P., Levy, Larry, Oh, Julia L., Strom, Eric A., Perkins, George H., Buchholz, Thomas A., & Woodward, Wendy A., E-mail: wwoodward@mdanderson.org. Long-Term Outcomes in Patients With Isolated Supraclavicular Nodal Recurrence After Mastectomy and Doxorubicin-Based Chemotherapy for Breast Cancer. United States. doi:10.1016/j.ijrobp.2010.04.015.
Reddy, Jay P., Levy, Larry, Oh, Julia L., Strom, Eric A., Perkins, George H., Buchholz, Thomas A., and Woodward, Wendy A., E-mail: wwoodward@mdanderson.org. Mon . "Long-Term Outcomes in Patients With Isolated Supraclavicular Nodal Recurrence After Mastectomy and Doxorubicin-Based Chemotherapy for Breast Cancer". United States. doi:10.1016/j.ijrobp.2010.04.015.
@article{osti_21587639,
title = {Long-Term Outcomes in Patients With Isolated Supraclavicular Nodal Recurrence After Mastectomy and Doxorubicin-Based Chemotherapy for Breast Cancer},
author = {Reddy, Jay P. and Levy, Larry and Oh, Julia L. and Strom, Eric A. and Perkins, George H. and Buchholz, Thomas A. and Woodward, Wendy A., E-mail: wwoodward@mdanderson.org},
abstractNote = {Purpose: To examine the outcome of patients who developed an isolated locoregional recurrence (LRR) involving the supraclavicular fossa (SCV) after initial treatment with modified radical mastectomy and chemotherapy. Methods and Materials: Records from 140 breast cancer patients treated on five prospective trials with mastectomy and doxorubicin-based chemotherapy, with or without radiation, who developed a LRR were reviewed. Kaplan-Meier survival times were calculated using date of LRR as time zero. Results: The median follow-up after LRR was 2.9 years (N = 140; interquartile range, 1.3-6.6 years). In all, 47 of 140 patients (34%) had an SCV component to their LRR. These patients had lower 3-y distant metastasis-free survival (40% vs. 54%, p = 0.003) and overall survival (49% vs. 69%, p = 0.04) than patients without an SCV component. Multivariate analysis revealed that LRR involving an SCV component (hazard ratio, 1.96, p = 0.004) and patients with lymphovascular space invasion in their primary tumors (hazard ratio, 1.65, p = 0.029) were independently associated with a poor distant metastasis-free survival. However, among 23 patients with isolated SCV recurrence, Overall survival was not statistically significantly different between isolated chest wall recurrence and isolated SCV recurrence. Patients with isolated SCV recurrence displayed a median follow-up of 3.3 years (IR, 1.2-5.2). Only 6 LRR of 23 patients were treated with aggressive local therapy, including surgery, chemotherapy, and radiation (alone or in combination). Conclusions: Although breast cancer recurrence with SCV involvement carries a high risk of distant metastasis and death, among women with recurrence limited to the SCV alone, overall survival after isolated SCV recurrence can be long (25% >5 years).},
doi = {10.1016/j.ijrobp.2010.04.015},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 80,
place = {United States},
year = {2011},
month = {8}
}