fullofbeans--this one is for you! from ASCO

[Lani]

these authors feel supraclavicular metastasis should be lumped with axillary metastasis and reflect advanced disease but not distant metastasis in terms of prognosis (ie, better) and found an almost two-fold improvement in survival if they took the nodes out. One caveat--it seems all their studies were ipsilateral ie, none bilateral, but still it sounds promising.

if you judt let them just irradiate you will never know what you are fighting and what best to fight it with and you will deprive yourself of the results of this report ie, surgical removal does help prognosis.

Hope this helps!!

PS I tried to find the poster presenter to ask questions, but failed.

Also, do not let the stats freak you out as yours is her2+ breast cancer, an entirely different animal and they are developing more and more effective treatments against it all the time.


Survival benefit of neck dissection for patients with breast cancer with supraclavicular lymph node metastasis.

Sub-category: Metastatic Breast Cancer

Category: Breast Cancer - Metastatic Breast Cancer

Meeting: 2010 ASCO Annual Meeting


Citation: J Clin Oncol 28:7s, 2010 (suppl; abstr 1069)

Abstract No: 1069


Attend this session at the ASCO Annual Meeting!
Session: Breast Cancer - Metastatic

Type: General Poster Session

Time: Saturday June 5, 2:00 PM to 6:00 PM

Location: S Hall A2

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Author(s): S. Chen; Chang Gung Memorial Hospital, Taipei, Taiwan


Abstract:

Background: The incidence and outcome of supraclavicular lymph node metastasis (SLNM) were poorly defined for it had been combined with axillary relapse as regional nodal failure in the literatures, and further surgical treatment for the regional nodal relapse had never been evaluated. Methods: A total of 5,409 consecutive women with primary breast cancer who received surgical treatment in the single institute from 1990 to 2003 were included in the study. Isolated chest wall recurrence as first event was defined as local relapse. SLNM was defined as only isolated ipsilateral site neck nodal recurrence. All SLNM had tissue proof. Neck dissection defined as curative intent to remove all nodes and soft tissue in neck level IV and part of III and V, incisional or excisional biopsy of neck node were not included. Median follow up was 84 months. Results: There were 271 patients (5.0%) developed local relapse and 127 patients (2.3%) suffered from SLNM. Forty-nine in 127 SLNM patients had received neck dissection. There were no significant differences of age distribution, initial tumor size, axillary nodal involvement, estrogen and progesterone receptor, HER2/neu status, level II dissection, adjuvant chemotherapy, hormonal therapy, and radiotherapy between the two groups of neck dissection or not. The 5, 10 years overall survival (OS) for local relapse, SLNM and distant metastasis were, 38.7%, 26.1%; 21%, 9.2%, and 13.8%, 7.0%, respectively. The 5, 10 years OS for those received neck dissection or not were 30.6%, 16.1%, and 14.9% 4.7% (p=0.002); the 5, 10 years distant metastasis-free survival were 16.3%, 8.2%, and 8.5, 3.8%, respectively (p=0.004). In multivariate analysis, neck dissection, disease-free interval, and hormonal therapy were independent prognostic factor for survival, the hazard ratio, 95% confidence interval were 1.715 (1.165 ~ 2.524), 1.473 (1.016 ~ 2.137) and 1.490 (1.023 ~ 2.169), respectively. Conclusions: Isolated SLNM should not consider as distant metastasis, and aggressive surgery is benefit for patients.

[Lani]

bringing this back up as has new information on treatment of involved supraclavicular nodes, prognostic meaning of involved SC nodes

Haven't heard a peep out of fullofbeans

Hope she took her time to explore all the options before "leaping in"

[fullofbeans]

Thank you so much Lani and for your best wishes and Ellie as well these are greatly appreciated.

I am still investigating as we speak and almost ready to make my move, but yes treating it directly was already my logical conclusion too (just like I did for my liver), likely to involve cryo might be on the card with immuno thrwon in for good measure, will let you know when back to NED I will be soon, end of.

Lani I am not panicking the stat are much better than when I had 6 tumours in my liver.. simply assessing full time my particular case with my somewhat limited financial means and what is out there. for example the laser treatment for my liver were shown to have same results than resection, but surgery department seems to ignore that (interventional radiology is the future I think)..I have no scar and it was a day treatment going home in the evening..no comparable cost (i.e. i could have never afoorded a resection in any case, but now quite happy not to have scars). Unlike you guys in America resection in anycase was never offered to me so unlike many of you on this site I have to find my own way can't even get a blimmin PET to see if it is somewhere else I just have to hope..

That to say.. I have much hope, much , much of it and I already have made huge progress in where I am going with this as you can all see I beleive in being aggressive, I am a biologist and I think cancer is like a pest, same resitance process..and as mine is particularly fast (went from 1 papable node to 4 in 3 weeks..)

Once I made my move I'll let you know.

Still tremendously angry at the hospital for putting me in this situation by gross neglicence i.e. not looking on the scan at the breast of o breast cancer patient.. seems I always have to do everything, not sure what it is I have done to deserve a second lashing of it by such ridiculous failing on competences.. seems to me I have to prove another point..

thank you all in advance for all your good wishes and prayers to find something (affordable).. I doubt tykerb will be allowed by my pct.. maybe it all pushes to new better frontier she says with belief..

Much love