Isolated Contralateral Axillary Lymph Node Involvement in Breast Cancer Represents a Locally Advanced Disease Not Distant Metastases.

Autor: Chkheidze R; Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX., Sanders MAG; Department of Pathology, University of Louisville Hospital, Louisville, KY., Haley B; Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX., Leitch AM; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Sahoo S; Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: sunati.sahoo@utsouthwestern.edu.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2018 Aug; Vol. 18 (4), pp. 298-304. Date of Electronic Publication: 2017 Nov 10.
DOI: 10.1016/j.clbc.2017.10.019
Abstrakt: Background: Breast cancer metastases to an ipsilateral supraclavicular lymph node is assigned a N3 status in the TNM system and thus classified as stage III disease in the American Joint Commission on Cancer staging manual. Breast cancer metastatic to contralateral axillary lymph node (CAM) without metastases to any other distant organ is currently assigned M1 status (stage IV) instead of N3 (stage III).
Patients and Methods: We retrospectively reviewed the medical records of breast cancer patients diagnosed with CAM for their clinical presentation, pathologic diagnoses, treatment, and follow-up data. Patients who had distant metastases at the time of CAM diagnosis were excluded from the study.
Results: We report 12 breast cancer patients who developed CAM but no evidence of metastases in any other distant organ documented with extensive imaging workup. Imaging studies and thorough pathologic evaluation of the prophylactic total mastectomy specimen did not reveal a primary in the breast to account for the metastases in the axillary node.
Conclusion: Findings of our study as well as previous studies support that lymph node metastases in the contralateral axilla represents a locoregional spread of the tumor from the index breast via lymphatics rather than hematogenous spread. Therefore, isolated CAM in breast cancer patients should not be classified as stage IV disease.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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