A Multi-Center Cross-Sectional Investigation of the Diagnosis and Treatment of Breast Cancer with Synchronous Ipsilateral Supraclavicular Lymph Node Metastases Based on the CSBrs-009.

BACKGROUND:The diagnosis and management of breast cancer with ipsilateral supraclavicular lymph node metastases currently lack any applicable criteria or guidelines (ISLM), and diagnostic and treatment strategies are varied by medical centers. This study aimed to determine the current status of the diagnosis and treatment of breast cancer with ISLM among Chinese patients.METHODS:Data from 30 hospitals on ISLM breast cancer patients between January 1, 2018, and December 31, 2018, were systematically analyzed for the detection rate, clinicopathological characteristics, diagnosis and treatment strategies of breast cancer with ISLM among Chinese patients.RESULTS:A total of 26,723 women presented with breast cancer in 30 hospitals over the study period. A total of 127 ISLM breast cancer patients were finally enrolled. Synchronous ISLM without distant metastases was present in 0.48% of cases. The diagnosis of patients with 86.6% of ISLM was based on ultrasound examinations. The proportion of ISLM diagnosed by fine-needle aspiration biopsy (FNA) or core-needle biopsy (CNB) before surgery was 16.5% and 37.0%, respectively. Moreover, 45.7% of the ISLM patients had no pathological evidence. Regarding treatment strategies, 69.3% of ISLM patients received neoadjuvant chemotherapy (NAC) for more than 4 cycles, while 15.7% of patients did not receive NAC. 86.6% of ISLM patients underwent a mastectomy, and breast-conserving surgery was performed in 3.9% of ISLM patients. Moreover, 41.7% of ISLM patients received supraclavicular lymph node dissection (SCLD), while 47.2% were not treated with SCLD.CONCLUSIONS:The overall detection rate of breast cancer in patients with ISLM is low in China and varies widely between hospitals. There is no consensus on the optimal diagnosis and treatment of patients with ISLM breast cancer.