[The influence factors of pathologic complete response of the ipsilateral supraclavicular lymph node of breast cancer after neoadjuvant chemotherapy].

ABSTRACT

Objective: To investigate the factors affecting the pathologic complete response (PCR) of the ipsilateral supraclavicular lymph node (ISLN) of breast cancer after neoadjuvant chemotherapy (NAC). Methods: A total of 178 patients with breast cancer who had primary ipsilateral supraclavicular lymph node metastasis (ISLNM), receiving NAC and subsequent ISLN dissection, were retrospectively reviewed. The single factor and multi factor analysis were carried out by the chi square test and the Logistic regression model. Results: The enrolled patients were all female, 28 to 74 years old. The rate of PCR on the ISLN was 52.2%. Single factor analysis showed that KI67 expression level (χ(2)=7.717,P=0.005), breast PCR (bPCR) (χ(2)=33.564,P<0.001), and axillary PCR (aPCR) (χ(2)=31.750, P<0.001) were associated with the ISLN PCR. Multifactor analysis showed that KI67 expression level (OR=4.096, 95%CI 1.176-14.263, P=0.027), bPCR (OR=4.452, 95%CI 1.894-10.461, P<0.001) and aPCR (OR=5.183, 95%CI 1.974-13.605, P<0.001) were independent predictors of ISLN PCR. The rate of PCR on the ISLN was 90.9% in the patients with KI67>30% and simultaneous breast and axilla PCR. Conclusions: The PCR rate of the ISLN after neoadjuvant chemotherapy is higher than that of the breast and axillary PCR. The expression level of KI67, the bPCR and the aPCR are independent predictors of the PCR on the ISLN.