In a nutshell
This study investigated the frequency and outcomes of contralateral axillary metastasis (CAM) in patients with inflammatory breast cancer (IBC). The data showed that CAM was common at diagnosis in patients with IBC and was best identified by ultrasound and positron emission tomography (PET).
Some background
IBC is a rare and aggressive form of BC, accounting for 2% of all BCs. It is termed 'inflammatory' as the breast appears red, swollen, and 'inflamed'. Metastasis (the spread of cancer to distant organs) is typically observed in 30% of all new IBC cases. Standard treatment for IBC is usually chemo-radiotherapy, surgery, and targeted therapies.
BC can also spread into the close lymph nodes in the armpit. They usually spread in the armpit close to where the IBC is. However, it can also spread to the opposite armpit (contralateral axillary metastasis or CAM). CAM in patients with BC is very rare. However, there are no studies investigating the frequency and outcomes of CAM in patients with IBC.
Methods & findings
This study involved 588 women with IBC. 49 patients (8.3%) had CAM. The average follow-up time was 34 months.
The best methods that best detected CAM in patients with IBC were ultrasound and PET scans (over 90%). Mammography and MRI scans had lower detection capacity (sensitivity).
After systemic (whole-body) therapy, 22 patients had surgery in the opposite armpit and 18 patients received additional node radiation therapy in the opposite armpit.
Overall, patients with CAM had poorer survival compared to those without CAM. However, patients with CAM who received surgery or radiation for the CAM had 68% better survival compared to those who were not treated for CAM.
The bottom line
This study concluded that CAM was common in patients with IBC and was best identified by ultrasound and PET. The authors recommend opposite armpit ultrasound as a routine checkup for all patients with IBC.
The fine print
The sample size was small and the follow-up time was too short. The definition of CAM was not consistent in different studies.
Published By :
Annals of Surgical Oncology
Date :
Jun 14, 2021
