ABSTRACT

Purpose:

Breast cancer patients with infraclavicular metastasis are considered to have stage IIIC and locally advanced disease according to the American Joint Committee on Cancer (AJCC) TNM classification. The prognostic significance of infraclavicular metastasis in breast cancer patients was evaluated.

Patients and Method:

Among 890 surgically treated breast cancer patients, 428 (48%) had axillary metastasis. These patients with axillary metastasis were divided into two groups: patients with and without infraclavicular lymph node metastasis. The clinicopathologic factors of these two groups were evaluated with respect to local recurrence and systemic metastasis.

Results:

Among the 428 patients with level I and II axillary metastasis, 183 (42.8%) had infraclavicular metastasis. Patients with young age, pre-menopausal status, large tumor size, high-grade tumor, lymphatic and vascular invasion, extranodal invasion and axillary lymph node metastasis >4 were significantly higher in the infraclavicular metastasis group (p<0.05). Although local recurrences and systemic metastasis in the group with infraclavicular metastasis were higher, disease-free and overall survival rates were lower than those in the nonmetastatic group; these differences were not statistically significant.

Conclusion:

There was a significant correlation between infraclavicular lymph node metastasis and age, menopausal status, tumor size, tumor grade, lymphatic and vascular invasion, number of axillary lymph node metastases and extranodal invasion. The number of axillary lymph node metastases was an independent risk factor for infraclavicular metastasis.