Clinical Significance of Supraclavicular Lymph Node Dissection for Breast Cancer Patients With Ipsilateral Supraclavicular Lymph Node Metastasis
Clinical Significance of Supraclavicular Lymph Node Dissection for Breast Cancer Patients With Ipsilateral Supraclavicular Lymph Node Metastasis
Breast cancer patients with ipsilateral supraclavicular lymph node metastasis are defined as
 Ⅲc stage (N3) according to the newly published 8th AJCC TNM staging system. No concret guide
 line was supported to such patients. It is still pending whether to exert supraclavicular
 lymph node dissection to breast cancer patients with ipsilateral supraclavicular lymph node
 metastasis.

 To evaluate the clinical significance and complication of supraclavicular lymph node
 dissection for breast cancer patients with ipsilateral supraclavicular lymph node metastasis,
 the investigators randomize patients into two groups, one group is supraclavicular lymph node
 dissection with radiotherapy group, the other group is radiotherapy group.
Breast cancer is the most common cancer and the leading cause of deaths from cancer in women
 worldwide. Breast cancer patients with ipsilateral supraclavicular lymph node metastasis are
 defined as Ⅲc stage (N3) according to the newly published 8th AJCC TNM staging system.
 Clinical outcomes are similar for patients with ipsilateral supraclavicular lymph node
 metastases at first presentation and for patients with recurrent ipsilateral supraclavicular
 lymph node metastases. The survival rate was lower in patients with ipsilateral
 supraclavicular lymph node metastases than in patients with lower axillary or subclavian
 nodal involvement. No concrete guide line was supported to such patients. It is still pending
 whether to exert supraclavicular lymph node dissection to breast cancer patients with
 ipsilateral supraclavicular lymph node metastasis. Patients with ipsilateral supraclavicular
 lymph node metastases who were treated with surgery or radiotherapy and achieved good neck
 control were reported to achieve better survival than those for whom surgical treatment or
 irradiation did not result in good local control.

 Patients with ipsilateral supraclavicular lymph node metastases should be offered a combined
 modality approach, including systemic therapy, surgery, and radiotherapy. Furthermore, local
 treatment, usually including axillary and supraclavicular lymph node, either by surgical
 clearance or by radical radiotherapy, can prevent the tumor cells from drainage, might be
 play a more important role. However, the role of surgical removal of the supraclavicular
 nodes is uncertain compared with radical radiotherapy. To our knowledge, the available
 literature comparing these two local treatments of ipsilateral supraclavicular lymph node
 metastases is scarce. Furthermore, the studies comparing the outcome of dissection of
 supraclavicular lymph node combined with local radiotherapy and radiotherapy of
 supraclavicular lymph node is also rare. All the related reports up to date have mixed them
 up.

 To evaluate the clinical significance and complication of supraclavicular lymph node
 dissection for breast cancer patients with ipsilateral supraclavicular lymph node metastasis,
 we randomize patients into two groups, one group is supraclavicular lymph node dissection
 with radiotherapy group, the other group is radiotherapy group.

 Therefore, in addition to investigating the role of surgical removal of the supraclavicular
 nodes in Chinese patients, we also try to reveal the potential difference between these two
 treatments, hoping to bring more insight into clinical practice.
Inclusion Criteria:

 1. Ability to understand the study procedures and contents, and willingness to
 voluntarily sign the written informed consent form;

 2. Age≤75 years old, female;

 3. Histologically confirmed breast cancer;

 4. Histologically or cytologically confirmed ipsilateral supraclavicular lymph node
 metastasis；

 5. cT0-T3；

 6. low and moderate risk for anesthesia

 Exclusion Criteria:

 1. Absolute and relative contraindication for surgery or radiation；

 2. existing distant metastasis before surgery；

 3. non-invasive breast cancer；

 4. with contralateral breast cancer；

 5. Previous history of breast cancer or other malignancies；

 6. ECOG≥2；

 7. inflammatory breast cancer；

 8. pregnancy；

 9. any serious complications which caused patients not suitable to participate this study