|
|
|
| Analysis of 5-year Survival Rate and Prognosis of Breast Cancer with Ipsilateral Supraclavicular Lymph Node Metastasis |
| CHE Ya |
| Department of Radiotherapy, Shangluo Central Hospital, Shaanxi Province, 726000 |
|
|
|
|
Abstract 【Objective】To investigate the 5-year survival rate and prognostic factors of breast cancer patients with ipsilateral supraclavicular lymph node metastasis. 【Methods】A total of 110 locally advanced triple negative invasive breast cancer (TNBC) with ipsilateral supraclavicular lymph node metastasis but no distant metastasis admitted to our hospital were enrolled in the study. The patients all received 4-6 cycles of neoadjuvant chemotherapy, followed by surgery and radiotherapy. Patients' 5-year survival rates were recorded and factors affecting disease-free survival (DFS) and overall survival (OS) were analyzed. 【Results】 The follow-up time was 54-72 months. The median follow-up time was 65.2 months. A total of 49 deaths occurred. The 5-year survival rate was 55.45% (61/110) with median survival time 31.9 months. The 5-year survival rates of patients with negative supraclavicular lymph node metastasis and pathological complete remission (pCR) after surgery was 73.68% (28/38) and 81.82% (18/22), which were higher than those of supraclavicular lymph node-positive metastasis 52.78% (38/72) and non-pCR patients 54.55% (48/88), (P<0.05). Kaplan-Meier method and Log-rank test showed that the size of supraclavicular lymph nodes before chemotherapy, Ki-67 level in pre-chemotherapy breast tissue, supraclavicular lymph node status after chemotherapy, axillary lymph node status, subclavian lymph node status, pCR and ipsilateral supraclavicular lymph node status after chemotherapy were correlated with DFS (P<0.05); and age, Ki-67 staining in pre-chemotherapy breast cancer, supraclavicular lymph node status, axillary lymph node status, and pCR were associated with OS as well (P<0.05). Cox multivariate analysis showed that the metastatic status of supraclavicular lymph node, axillary lymph node and subclavian lymph node, and pCR were independent influencing factors of DFS (P<0.05) after chemotherapy. Age, supraclavicular lymph node status after chemotherapy and pCR were independent factors of OS (P<0.05). 【Conclusion】The 5-year survival rate of triple-negative breast cancer with ipsilateral supraclavicular lymph node metastasis is improved after comprehensive treatment. The status of supraclavicular lymph node and pCR after chemotherapy are important factors influencing prognosis.
|
|
Received: 25 October 2019
|
|
|
|
|
|
[1] Tryfonidis K, Senkus E, Cardoso MJ, et al. Management of locally advanced breast cancer-perspectives and future directions[J].Nat Rev Clin Oncol,2015,12(3):147-162.
[2] Denkert C, Liedtke C, Tutt A, et al. Molecular alterations in triple-negative breast cancer-the road to new treatment strategies[J].Lancet,2017,389(10087):2430-2442.
[3] Chue BM, La Course BD. Case report of long-term survival with metastatic triple-negative breast carcinoma: Treatment possibilities for metastatic disease[J].Medicine (Baltimore),2019,98(16):e15302.
[4] Yu J.The pattern of lymphatic metastasis of breast cancer and its influence on the delineation of radiation fields[J].Int J Radiat Oncol Biol Phys,2005,61(3):874-878.
[5] Jitariu AA. Triple negative breast cancer: the kiss of death[J].Oncotarget,2017,8(28):46652-46662.
[6] 李帅,王淑莲,李晔雄, 等.乳腺癌保乳术后1～3个腋窝淋巴结阳性者锁骨上淋巴结复发风险分析[J].中华放射肿瘤学杂志,2015,24(2):149-153.
[7] 马丹丹,齐晓伟,张毅, 等.乳腺癌伴同时型同侧锁骨上淋巴结转移患者新辅助化疗后锁骨上淋巴结阳性的危险因素及预后分析[J].中华乳腺病杂志(电子版),2019,13(2):87-92.
[8] Wein L, Loi S. Mechanisms of resistance of chemotherapy in early-stage triple negative breast cancer (TNBC)[J].Breast,2017,34 Suppl 1:S27-S30.
[9] Li J, Chen S, Chen C, et al. Pathological complete response as a surrogate for relapse-free survival in patients with triple negative breast cancer after neoadjuvant chemotherapy[J].Oncotarget,2017,8(11):18399-18408. |
|
|
|
2020, Vol. 37 
