Treatment of breast cancer with ipsilateral supraclavicular node metastases

During 1954-1977, among 2803 cases of breast cancer 99 (3.5%) had ipsilateral supraclavicular node mestastases. The results of treatment are reported, based on follow-up for more than 10 years. According to the treatment modality, the patients were divided into 4 groups: I. surgery with postoperative adjuvant chemotherapy and radiation therapy; II. radiation and chemotherapy; III. chemotherapy; IV. no treatment. In group I, surgical procedures consisted of segmental mastectomy in 6; simple mastectomy in 7; modified radical mastectomy in 16; standard radical mastectomy in 12, and extended radical mastectomy in 3. The over-all five-year survival rate was 9%. It was 18% (8/44) in group I, but only 5% (1/21) in group II. None survived for 5 years in group III and group IV. The results seem to indicate that more aggressive multi-modality treatment of breast cancer with ipsilateral supraclavicular lymph node metastases is indicated to expect better survival.