In addition, the clinicopathological factors were analyzed retrospectively.Īmong the 1148 patients with breast cancer, the patients who had suspicious SCNs in neck US, chest CT, or PET/CT underwent fine-needle aspiration cytology (FNAC) to confirm true metastasis. Locoregional recurrence (including recurrence in the breast, axilla, or supra/infraclavicular area), distant metastasis, and death were evaluated through blood tests, tumor markers, mammography, breast and neck US, chest X-ray, bone scan, chest (including neck area) or abdominal CT, and 18F-FDG PET/CT. After completing adjuvant treatments, each patient was followed up one or two times annually for at least five years for surveillance. The treatment strategy for patients with operable breast cancer was determined through multidisciplinary team discussions, which comprised breast and plastic surgeons, oncologists, radiologists, pathologists, radiation oncologists, and a rehabilitation physician. Informed consent was obtained from all patients and the protocol used in this study was approved by the Institutional Review Board Committee of the Kyungpook National University Chilgok Hospital (KNUCH 5), and all the experiments were performed in accordance with relevant guidelines and regulations.Ī total of 1148 patients with breast cancer who had undergone surgery between 20 were included in this study. Herein, the authors compared the statistical parameters of neck US, CT, and PET/CT in detecting SCN metastasis in breast cancer.Īll the procedures in this study were performed in accordance with the ethical standards of the institutional review board of the Kyungpook National University Chilgok Hospital. However, to the authors’ knowledge, there is no study that compares various imaging modalities for the detection of SCN metastasis in breast cancer. According to the National Comprehensive Cancer Network (NCCN) guidelines, although diagnostic contrast-enhanced chest CT is only recommended for clinical stages I–IIB with pulmonary symptoms, suspicious SCNs can be incidentally detected on neck areas shown in chest CT images ( 12).īased on several studies, the sensitivity and specificity were 75%–100% and 55%–99% for US, 25%–98% and 65%–99% for CT, and 74%–92% and 61%–79% for PET/CT, respectively ( 13– 16). Neck ultrasonography (US), computed tomography (CT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) have been used for the detection of SCN metastasis in breast cancer ( 9– 11). However, early detection of SCN metastasis may improve the operability and expand the opportunities for curative therapy ( 6– 8). The breast cancer recurrence in the axillary lymph nodes is generally surgically removable and shows better prognosis than the recurrence in supraclavicular lymph nodes (SCNs), which does not show good prognosis even if it has been removed because of concurrent or subsequent distant metastases ( 5). Supraclavicular lymph nodes (SCNs) are one of the common sites of regional recurrence of breast cancer. However, paradoxically, the incidence of recurrence or metastasis has increased with the prolonged overall survival period. The overall survival and mortality rates of patients with cancer have improved with early diagnosis and the development of new treatment modalities ( 1– 4).
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