PURPOSE: The incidence of supraclavicular metastasis as the initial failure and the failure patterns in patients with four or more positive axillary lymph nodes (PALNs) after breast-conserving therapy (BCT) without prophylactic supraclavicular irradiation were investigated. MATERIALS AND METHODS: Between 1991 and 2002, a total of 48 women with four or more PALNs underwent BCT without prophylactic supraclavicular irradiation (33 patients with 4-9 PALNs; 15 patients with > or =10 PALNs). RESULTS: The median follow-up time was 50 months. Among the patients with 4-9 PALNs, 3% had isolated supraclavicular metastasis as the initial failure, and 30% had distant metastasis as the initial failure. Among patients with > or =10 PALNs, 7% had isolated supraclavicular metastasis as the initial failure, and 40% had distant metastasis as the initial failure. The 4-year isolated supraclavicular failure rates were 5% for all patients, 3% for patients with 4-9 PALNs, and 8% for patients with >/=10 PALNs. CONCLUSION: In patients who had undergone BCT and had had four or more PALNs, the major failure pattern was distant failure with or without locoregional failure; isolated supraclavicular failure as the initial failure comprised a less common failure pattern. Omission of prophylactic supraclavicular irradiation may be acceptable for this subset of patients.
PURPOSE: The incidence of supraclavicular metastasis as the initial failure and the failure patterns in patients with four or more positive axillary lymph nodes (PALNs) after breast-conserving therapy (BCT) without prophylactic supraclavicular irradiation were investigated. MATERIALS AND METHODS: Between 1991 and 2002, a total of 48 women with four or more PALNs underwent BCT without prophylactic supraclavicular irradiation (33 patients with 4-9 PALNs; 15 patients with > or =10 PALNs). RESULTS: The median follow-up time was 50 months. Among the patients with 4-9 PALNs, 3% had isolated supraclavicular metastasis as the initial failure, and 30% had distant metastasis as the initial failure. Among patients with > or =10 PALNs, 7% had isolated supraclavicular metastasis as the initial failure, and 40% had distant metastasis as the initial failure. The 4-year isolated supraclavicular failure rates were 5% for all patients, 3% for patients with 4-9 PALNs, and 8% for patients with >/=10 PALNs. CONCLUSION: In patients who had undergone BCT and had had four or more PALNs, the major failure pattern was distant failure with or without locoregional failure; isolated supraclavicular failure as the initial failure comprised a less common failure pattern. Omission of prophylactic supraclavicular irradiation may be acceptable for this subset of patients.
Authors: A Recht; S B Edge; L J Solin; D S Robinson; A Estabrook; R E Fine; G F Fleming; S Formenti; C Hudis; J J Kirshner; D A Krause; R R Kuske; A S Langer; G W Sledge; T J Whelan; D G Pfister Journal: J Clin Oncol Date: 2001-03-01 Impact factor: 44.544
Authors: J Ragaz; S M Jackson; N Le; I H Plenderleith; J J Spinelli; V E Basco; K S Wilson; M A Knowling; C M Coppin; M Paradis; A J Coldman; I A Olivotto Journal: N Engl J Med Date: 1997-10-02 Impact factor: 91.245
Authors: M Overgaard; M B Jensen; J Overgaard; P S Hansen; C Rose; M Andersson; C Kamby; M Kjaer; C C Gadeberg; B B Rasmussen; M Blichert-Toft; H T Mouridsen Journal: Lancet Date: 1999-05-15 Impact factor: 79.321
Authors: M Overgaard; P S Hansen; J Overgaard; C Rose; M Andersson; F Bach; M Kjaer; C C Gadeberg; H T Mouridsen; M B Jensen; K Zedeler Journal: N Engl J Med Date: 1997-10-02 Impact factor: 91.245
Authors: F A Vicini; E M Horwitz; M D Lacerna; D M Brown; J White; C F Dmuchowski; V R Kini; A Martinez Journal: Int J Radiat Oncol Biol Phys Date: 1997-12-01 Impact factor: 7.038
Authors: Rong Qin; Qiaoyu Zhang; Jianfeng Weng; Weiping Liu; Bo Zhang; Gang Lv; Yi Wang; Youjun Wu; Yongdong Pu Journal: Contemp Oncol (Pozn) Date: 2015-05-13