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作者

Liang Zhang, Xin Zhao Wang, Chao Li, Qian Yu, Zhaoyun Liu, Zhi Yong Yu

作者单位

Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China. Interventional Radiology, University of Chicago, Chicago, IL, United States. Affiliations

刊名

Frontiers in oncology

年份

2022

卷号

Vol.12

页码

869397

ISSN

2234-943X

关键词

breast cancer staging breast carcinoma (BC) contralateral axillary lymph node metastasis (CAM) local recurrence treatment strategy.

摘要

Background: Contralateral axillary lymph node metastasis is classified as distant metastasis in guidelines, but the prognosis is better than that of stage IV patients. It is controversial to classify CAM as a distant metastasis or a regional metastasis, and the optimal treatment strategy for CAM is unknown. Patients and methods: Breast cancer patients who were confirmed by pathology and treated at Shandong Cancer Hospital between January 2012 and July 2021 were included in our study. We retrosp...更多

Background: Contralateral axillary lymph node metastasis is classified as distant metastasis in guidelines, but the prognosis is better than that of stage IV patients. It is controversial to classify CAM as a distant metastasis or a regional metastasis, and the optimal treatment strategy for CAM is unknown. Patients and methods: Breast cancer patients who were confirmed by pathology and treated at Shandong Cancer Hospital between January 2012 and July 2021 were included in our study. We retrospectively reviewed the medical records of the patients for their clinical features, pathological diagnosis, treatment strategy, and follow-up data. Survival analysis was calculated by Kaplan-Meier analysis, and patient matching was performed by case-control matching. Results: A total of 60 patients were included, and there were 49 metachronous CAM cases and 11 synchronous CAM cases. The prognosis of isolated CAM patients was better than that of patients with other distant metastases in terms of CAM-OS and PFS with significant differences and OS without significant differences . The five-year survival rate of isolated CAM patients was 67.4%, and the five-year disease-free survival rate was 52.9%. The prognosis of CAM patients was similar to that of N3M0 patients in terms of OS and DFS . Axillary lymph node dissection or low-middle level ALND significantly improved the OS , CAM-OS , and PFS of isolated CAM patients. Axillary radiotherapy improved PFS, CAM-OS, and OS but without significant differences . Conclusion: CAM should be diagnosed as local recurrence and treated with aggressive and curative rather than palliative strategies. Contralateral axillary surgery and radiotherapy are recommended for isolated CAM patients.收起

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