Significance of axillary lymph node extranodal soft tissue extension and indications for postmastectomy irradiation

✍ Scribed by John E. Mignano; Marianna L. Zahurak; Anuradha Chakravarthy; Steven Piantadosi; William C. Dooley; Irene Gage

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 84 KB
• Volume: 86
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19991001)86:7<1258::aid-cncr22>3.0.co;2-s

✦ Synopsis

BACKGROUND.

Extranodal soft tissue extension of axillary lymph node metastases (ETE) has been considered an indication for postmastectomy radiotherapy, including the axilla. However, it is unclear whether patients with ETE are at an increased risk of axillary recurrence.

METHODS.

From a single institutional database of 2362 patients with breast carcinoma treated between 1974 -1994, a total of 487 patients who underwent mastectomy for lymph node positive, infiltrating (T1-T3) breast carcinoma was found. All the patients had pathologically confirmed axillary lymph node metastases and negative surgical margins; none had received postoperative irradiation. Of these patients, 50 had histologically documented axillary ETE. Forty-three patients had a minimum follow-up of at least 1 year and comprise the study population. The median follow-up time of surviving ETE positive patients was 79 months. Twentyfive patients (58.1%) received adjuvant systemic therapy. Sites of first failure were local or distant. Local failure was categorized further as chest wall failure, axillary failure, supraclavicular lymph node failure, or internal mammary lymph node failure.