Outcome of Breast-Conserving Treatment for Axillary Lymph Node Metastasis From Occult Breast Cancer With Negative Breast MRI
- Affiliated Author(s)
- 김진희
- Alternative Author(s)
- Kim, Jin Hee
- Journal Title
- Breast
- ISSN
- 1532-3080
- Issued Date
- 2019
- Keyword
- Neoplasms; Unknown primary; Breast neoplasm; Lymph nodes; Magnetic resonance imaging; Radiotherapy
- Abstract
- Purpose:
We conducted this study to investigate the prognosis and failure pattern after breast-conserving treatment (BCT) in patients with occult breast cancer (OBC) with negative breast magnetic resonance imaging (MRI) (MRI-OBC).
Materials and methods:
Survival rates and failure patterns in 66 patients who received axillary lymph node dissection (ALND) and BCT for MRI-OBC between 2001 and 2013 at seven hospitals were analyzed. OBC was defined as adenocarcinoma in the axillary lymph node (ALN) +/- supraclavicular (SCN) or internal mammary lymph node (IMN) with a negative breast MRI.
Results:
Fifty-four patients had only ALN metastasis (ALN only), and 12 patients had ALN metastasis along with SCN or IMN metastasis (ALN + SCN/IMN). Median follow-up was 82 months. The 5-year overall, disease-free, and breast cancer-free survival rates were 93.4%, 92.1%, and 96.8%, respectively. Nine patients experienced recurrence: breast (n = 4), regional lymph nodes (RLN, n = 1), distant metastases (DM, n = 2), breast/RLN (n = 1), and breast/RLN/DM (n = 1). Five-year disease-free survival was significantly higher in ALN only patients compared to ALN + SCN/IMN patients (96.1% vs. 75.0%; p = 0.02).
Conclusions:
Patients with MRI-OBC were successfully treated with BCT. There was a small risk of ipsilateral breast cancer recurrence. Failure patterns depended on the extent of initial disease.
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