Fabinshy Thangarajah1,2, Constanze Vogel3, Caroline Pahmeyer3, Christian Eichler3,2, Johannes Holtschmidt3, Dominik Ratiu3, Peter Mallmann3, Wolfram Malter3,2. 1. Department of Obstetrics and Gynecology, Medical Faculty, University Hospital Cologne, Cologne, Germany Fabinshy.Thangarajah@uk-koeln.de. 2. Breast Center-Department of Obstetrics and Gynecology, Medical Faculty, University Hospital Cologne, Cologne, Germany. 3. Department of Obstetrics and Gynecology, Medical Faculty, University Hospital Cologne, Cologne, Germany.
Abstract
BACKGROUND: Breast cancer is a heterogenous and complex disease. A rare site of metastatic breast cancer disease is the neck. Data about supraclavicular metastases in patients with metastatic breast cancer are still lacking. Hence, our study aimed to analyze histological subtypes of supraclavicular metastases compared to the primary site. MATERIALS AND METHODS: This was a retrospective hospital-based cohort study of patients with breast cancer who developed supraclavicular metastases. Diagnosis of supraclavicular metastases was confirmed by biopsy or diagnostic lymph node extirpation. Histological subtypes were analyzed and Kaplan-Meier estimates were calculated for overall survival. RESULTS: A total of 20 patients were included in the analysis. The majority of the patients (12/20) had hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative supraclavicular metastases, disease in 3/20 patients was HR-positive/HER2-positive, HR-negative/HER2-positive in 1/20 patients and basal-like in 4/20 patients. Total discordance rates for estrogen receptor, progesterone receptor and HER2 between primary and metastatic tumors were 20.0%, 36.8% and 29.4%, respectively. The 5-year overall survival was 80%, whereas the 5-year survival after the onset of neck metastasis was 45%. CONCLUSION: As a rare site of metastatic breast cancer, supraclavicular metastases are associated with a worse median overall survival from their onset. The high rate of discordance of histological subtype stresses the necessity for biopsies in patients with supraclavicular metastasis. Copyright
BACKGROUND:Breast cancer is a heterogenous and complex disease. A rare site of metastatic breast cancer disease is the neck. Data about supraclavicular metastases in patients with metastatic breast cancer are still lacking. Hence, our study aimed to analyze histological subtypes of supraclavicular metastases compared to the primary site. MATERIALS AND METHODS: This was a retrospective hospital-based cohort study of patients with breast cancer who developed supraclavicular metastases. Diagnosis of supraclavicular metastases was confirmed by biopsy or diagnostic lymph node extirpation. Histological subtypes were analyzed and Kaplan-Meier estimates were calculated for overall survival. RESULTS: A total of 20 patients were included in the analysis. The majority of the patients (12/20) had hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative supraclavicular metastases, disease in 3/20 patients was HR-positive/HER2-positive, HR-negative/HER2-positive in 1/20 patients and basal-like in 4/20 patients. Total discordance rates for estrogen receptor, progesterone receptor and HER2 between primary and metastatic tumors were 20.0%, 36.8% and 29.4%, respectively. The 5-year overall survival was 80%, whereas the 5-year survival after the onset of neck metastasis was 45%. CONCLUSION: As a rare site of metastatic breast cancer, supraclavicular metastases are associated with a worse median overall survival from their onset. The high rate of discordance of histological subtype stresses the necessity for biopsies in patients with supraclavicular metastasis. Copyright
Authors: Francisco J Civantos; Jan B Vermorken; Jatin P Shah; Alessandra Rinaldo; Carlos Suárez; Luiz P Kowalski; Juan P Rodrigo; Kerry Olsen; Primoz Strojan; Antti A Mäkitie; Robert P Takes; Remco de Bree; June Corry; Vinidh Paleri; Ashok R Shaha; Dana M Hartl; William Mendenhall; Cesare Piazza; Michael Hinni; K Thomas Robbins; Ng Wai Tong; Alvaro Sanabria; Andres Coca-Pelaz; Johannes A Langendijk; Juan Hernandez-Prera; Alfio Ferlito Journal: Front Oncol Date: 2020-11-10 Impact factor: 6.244