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Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer

BACKGROUND: To assess the frequency of IMLN recurrence, its associated risk factors with disease-free interval (DFI) and its predicting factors on overall survival time. METHODS: 133 cases of breast cancer IMLN recurrence were identified via the computerized CT reporting system between February 2003...

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Autores principales: Chen, Lei, Gu, Yajia, Leaw, Shiangjiin, Wang, Zhonghua, Wang, Peihua, Hu, Xichun, Chen, Jiayi, Lu, Jingsong, Shao, Zhimin
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941505/
https://www.ncbi.nlm.nih.gov/pubmed/20819231
http://dx.doi.org/10.1186/1471-2407-10-479
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author Chen, Lei
Gu, Yajia
Leaw, Shiangjiin
Wang, Zhonghua
Wang, Peihua
Hu, Xichun
Chen, Jiayi
Lu, Jingsong
Shao, Zhimin
author_facet Chen, Lei
Gu, Yajia
Leaw, Shiangjiin
Wang, Zhonghua
Wang, Peihua
Hu, Xichun
Chen, Jiayi
Lu, Jingsong
Shao, Zhimin
author_sort Chen, Lei
collection PubMed
description BACKGROUND: To assess the frequency of IMLN recurrence, its associated risk factors with disease-free interval (DFI) and its predicting factors on overall survival time. METHODS: 133 cases of breast cancer IMLN recurrence were identified via the computerized CT reporting system between February 2003 and June 2008, during which chest CT for patients with breast cancer (n = 8867) were performed consecutively at Cancer Hospital, Fudan University, Shanghai, China. Patients' charts were retrieved and patients' characteristics, disease characteristics, and treatments after recurrence were collected for analysis. The frequency was 1.5% (133/8867). RESULTS: IMLN recurrence was presented as the first metastatic site in 121 (91%) patients while 88 (66.2%) had other concurrent metastases. Typical chest CT images included swelling of the IMLN at the ipsilateral side with local lump and sternal erosion located mostly between the second and third intercostal space. The median disease-free interval (DFI) of IMLN recurrence was 38 months. The independent factors that could delay the IMLN recurrence were small tumor size (HR 0.5 95%CI: 0.4 - 0.8; p = 0.002), and positive ER/PR disease (HR 0.6, 95% CI: 0.4 - 0.9; p = 0.006). The median survival time after IMLN recurrence was 42 months, with a 5-year survival rate of 30%. Univariate analysis showed four variables significantly influenced the survival time: DFI of IMLN recurrence (p = 0.001), no concurrent distant metastasis (p = 0.024), endocrine therapy for patients with positive ER/PR (p = 0.000), radiotherapy (p = 0.040). The independent factors that reduced the death risk were no concurrent distant metastases (HR: 0.7, 95% CI: 0.4 - 0.9; p = 0.031), endocrine therapy for patients with positive ER/PR status (HR: 0.2, 95% CI: 0.1 - 0.5; p = 0.001) and palliative radiotherapy (HR: 0.3, 95% CI: 0.1- 0.9; p = 0.026). CONCLUSIONS: The risk of IMLN recurrence is low and there are certain characteristics features on CT images. ER/PR status is both a risk factor for DFI of IMLN recurrence and a prognostic factor for overall survival after IMLN recurrence. Patients with only IMLN recurrence and/or local lesion have a good prognosis.
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spelling pubmed-29415052010-09-18 Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer Chen, Lei Gu, Yajia Leaw, Shiangjiin Wang, Zhonghua Wang, Peihua Hu, Xichun Chen, Jiayi Lu, Jingsong Shao, Zhimin BMC Cancer Research Article BACKGROUND: To assess the frequency of IMLN recurrence, its associated risk factors with disease-free interval (DFI) and its predicting factors on overall survival time. METHODS: 133 cases of breast cancer IMLN recurrence were identified via the computerized CT reporting system between February 2003 and June 2008, during which chest CT for patients with breast cancer (n = 8867) were performed consecutively at Cancer Hospital, Fudan University, Shanghai, China. Patients' charts were retrieved and patients' characteristics, disease characteristics, and treatments after recurrence were collected for analysis. The frequency was 1.5% (133/8867). RESULTS: IMLN recurrence was presented as the first metastatic site in 121 (91%) patients while 88 (66.2%) had other concurrent metastases. Typical chest CT images included swelling of the IMLN at the ipsilateral side with local lump and sternal erosion located mostly between the second and third intercostal space. The median disease-free interval (DFI) of IMLN recurrence was 38 months. The independent factors that could delay the IMLN recurrence were small tumor size (HR 0.5 95%CI: 0.4 - 0.8; p = 0.002), and positive ER/PR disease (HR 0.6, 95% CI: 0.4 - 0.9; p = 0.006). The median survival time after IMLN recurrence was 42 months, with a 5-year survival rate of 30%. Univariate analysis showed four variables significantly influenced the survival time: DFI of IMLN recurrence (p = 0.001), no concurrent distant metastasis (p = 0.024), endocrine therapy for patients with positive ER/PR (p = 0.000), radiotherapy (p = 0.040). The independent factors that reduced the death risk were no concurrent distant metastases (HR: 0.7, 95% CI: 0.4 - 0.9; p = 0.031), endocrine therapy for patients with positive ER/PR status (HR: 0.2, 95% CI: 0.1 - 0.5; p = 0.001) and palliative radiotherapy (HR: 0.3, 95% CI: 0.1- 0.9; p = 0.026). CONCLUSIONS: The risk of IMLN recurrence is low and there are certain characteristics features on CT images. ER/PR status is both a risk factor for DFI of IMLN recurrence and a prognostic factor for overall survival after IMLN recurrence. Patients with only IMLN recurrence and/or local lesion have a good prognosis. BioMed Central 2010-09-07 /pmc/articles/PMC2941505/ /pubmed/20819231 http://dx.doi.org/10.1186/1471-2407-10-479 Text en Copyright ©2010 Chen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chen, Lei
Gu, Yajia
Leaw, Shiangjiin
Wang, Zhonghua
Wang, Peihua
Hu, Xichun
Chen, Jiayi
Lu, Jingsong
Shao, Zhimin
Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
title Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
title_full Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
title_fullStr Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
title_full_unstemmed Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
title_short Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
title_sort internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941505/
https://www.ncbi.nlm.nih.gov/pubmed/20819231
http://dx.doi.org/10.1186/1471-2407-10-479
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