Tactics of combined/complex treatment of patients with breast cancer with isolated metastatic lesions of supraclavicular or parasternal lymph nodes

DOI: https://doi.org/10.29296/25877305-2024-02-14
Issue: 
2
Year: 
2024

P. Kupriyanov(2); A. Zikiryakhodzhaev(1–3), MD; Professor I. Reshetov(2), Academician of the Russian Academy of Sciences, MD; E. Rasskazova(1), Candidate of Medical Sciences; F. Khugaeva(1), Yu. Butova(1), I. Duadze(2)
1-P.A. Herzen Moscow Research Oncology Institute – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia
2-I.M. Sechenov First Moscow State Medical University, Ministry of Health
of Russia (Sechenov University)
3-Peoples' Friendship University of Russia, Moscow

Purpose. To evaluate the treatment tactics for patients with breast cancer (BC) with isolated metastatic lesions of the supraclavicular or parasternal lymph nodes (LNs). Material and methods. We analyzed the data of 134 patients with breast cancer, who were divided into 2 groups: 1st (n=83) – patients with lesions of the supraclavicular and parasternal lymph nodes, both isolated and in combination with lesions of any other groups of lymph nodes; 2nd (n=51) – patients with isolated or combined lesions of only subclavian or axillary lymph nodes. In group 1, lymphadenectomy was performed in 27 patients (subgroup 1A), radiation therapy of the affected lymph nodes was performed in 56 (subgroup 1B). In group 2, patients received chemotherapy for the affected lymph nodes. Results. Survival after 1 year of observation was almost the same in subgroups 1A (surgical treatment of lymph nodes) and 1B (radiation therapy of lymph nodes) – 96.3 and 96.4%, respectively; after 3 years of observation – 77.8 and 80.4%, respectively; 5-year survival rate – 33.3 and 44.6%, respectively. However, the data obtained were statistically unreliable. Conclusion. When comparing 5-year overall survival, surgical removal of metastatic supraclavicular and parasternal lymph nodes is inferior to radiation therapy. Thus, it can be assumed that excluding the surgical stage of LN treatment does not worsen the results of therapy in the group of patients with breast cancer and metastatic lesions of supraclavicular or parasternal LNs.
Keywords: 
breast cancer
parasternal lymph nodes
supraclavicular lymph nodes
combined treatment
complex treatment
lymphadenectomy
rehabilitation
prognosis.

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