Outcome of breast-conserving treatment for axillary lymph node metastasis from occult breast cancer with negative breast MRI
Haeyoung Kim,
Won Park,
Su Ssan Kim,
Sung Ja Ahn,
Yong Bae Kim,
Tae Hyun Kim,
Jin Hee Kim,
Jin-Hwa Choi,
Hae Jin Park,
Jee Suk Chang,
Doo Ho Choi
Affiliations
Haeyoung Kim
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Won Park
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Corresponding author. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 06351, South Korea.
Su Ssan Kim
Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Corresponding author. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Sung Ja Ahn
Chonnam National University Medical School, Gwangju, South Korea
Yong Bae Kim
Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Tae Hyun Kim
Research Institute and Hospital, National Cancer Center, Goyang, South Korea
Jin Hee Kim
Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
Jin-Hwa Choi
Chung-Ang University Hospital, China
Hae Jin Park
Hanyang University College of Medicine, Seoul, South Korea
Jee Suk Chang
Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Doo Ho Choi
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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.
