TY - JOUR
T1 - Long-term results of combined-modality therapy for locally advanced breast cancer with ipsilateral supraclavicular metastases
T2 - The University of Texas M.D. Anderson Cancer Center experience
AU - Brito, R. A.
AU - Valero, V.
AU - Buzdar, A. U.
AU - Booser, D. J.
AU - Ames, F.
AU - Strom, E.
AU - Ross, M.
AU - Theriault, R. L.
AU - Frye, D.
AU - Kau, S. W.
AU - Asmar, L.
AU - McNeese, M.
AU - Singletary, S. E.
AU - Hortobagyi, G. N.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2001/2/1
Y1 - 2001/2/1
N2 - Purpose: To determine outcomes in local-regional control, disease-free survival, and overall survival in patients with locally advanced breast cancer (LABC) who present with ipsilateral supraclavicular metastases and who are treated with combined-modality therapy. Patients and Methods: Seventy patients with regional stage IV LABC, which is defined by our institution as LABC with ipsilateral supraclavicular adenopathy without evidence of distant disease, received treatment on three prospective trials of neoadjuvant chemotherapy. All patients received neoadjuvant chemotherapy with cyclophosphamide, doxorubicin, and vincristine, and prednisone. Patients then received local therapy that consisted of either total mastectomy and axillary lymph node dissection (ALND) or segmental mastectomy and ALND before or after irradiation. Patients with no response to neoadjuvant chemotherapy were treated with surgery and/or radiotherapy. After completion of local therapy, chemotherapy was continued for four to 15 cycles, followed by radiotherapy. Patients older than 50 years who had estrogen receptor-positive tumors received tamoxifen for 5 years. Results: Median follow-up was 11.6 years (range, 4.8 to 22.6 years). Disease-free survival rates at 5 and 10 years were 34% and 32%, respectively. The median disease-free survival was 1.9 years. Overall survival rates at 5 and 10 years were 41% and 31%, respectively. The median overall survival was 3.5 years. The overall response rate (partial and complete responses) to induction chemotherapy was 89%. No treatment related deaths occurred. Conclusion: Patients with ipsilateral supraclavicular metastases but no other evidence of distant metastases warrant therapy administered with curative intent, ie, combined-modality therapy cosisting of chemotherapy, surgery, and radiotherapy. Patients with ipsilateral supraclavicular metastases should be included in the stage IIIB category of the tumor-node-metastasis classification becuase their clinical course and prognosis are similar to those of patients with stage IIIB LABC.
AB - Purpose: To determine outcomes in local-regional control, disease-free survival, and overall survival in patients with locally advanced breast cancer (LABC) who present with ipsilateral supraclavicular metastases and who are treated with combined-modality therapy. Patients and Methods: Seventy patients with regional stage IV LABC, which is defined by our institution as LABC with ipsilateral supraclavicular adenopathy without evidence of distant disease, received treatment on three prospective trials of neoadjuvant chemotherapy. All patients received neoadjuvant chemotherapy with cyclophosphamide, doxorubicin, and vincristine, and prednisone. Patients then received local therapy that consisted of either total mastectomy and axillary lymph node dissection (ALND) or segmental mastectomy and ALND before or after irradiation. Patients with no response to neoadjuvant chemotherapy were treated with surgery and/or radiotherapy. After completion of local therapy, chemotherapy was continued for four to 15 cycles, followed by radiotherapy. Patients older than 50 years who had estrogen receptor-positive tumors received tamoxifen for 5 years. Results: Median follow-up was 11.6 years (range, 4.8 to 22.6 years). Disease-free survival rates at 5 and 10 years were 34% and 32%, respectively. The median disease-free survival was 1.9 years. Overall survival rates at 5 and 10 years were 41% and 31%, respectively. The median overall survival was 3.5 years. The overall response rate (partial and complete responses) to induction chemotherapy was 89%. No treatment related deaths occurred. Conclusion: Patients with ipsilateral supraclavicular metastases but no other evidence of distant metastases warrant therapy administered with curative intent, ie, combined-modality therapy cosisting of chemotherapy, surgery, and radiotherapy. Patients with ipsilateral supraclavicular metastases should be included in the stage IIIB category of the tumor-node-metastasis classification becuase their clinical course and prognosis are similar to those of patients with stage IIIB LABC.
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U2 - 10.1200/JCO.2001.19.3.628
DO - 10.1200/JCO.2001.19.3.628
M3 - Article
C2 - 11157012
AN - SCOPUS:0035253701
SN - 0732-183X
VL - 19
SP - 628
EP - 633
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 3
ER -