背景：同时发生同侧锁骨上淋巴结转移（ISLNM）的乳腺癌患者预后不良。锁骨上淋巴结清扫术（SLND）作为手术干预治疗这种疾病的作用仍然存在争议。在这项研究中，我们的目的是评估与 ISLNM 乳腺癌相关的预后因素，并评估积极的局部手术治疗对患者预后的潜在影响。方法：我们对 2000 年至 2020 年间在我们机构接受治疗性治疗的 250 名 ISLNM 乳腺癌患者进行了回顾性分析。该队列根据腋窝手术的范围进行分组。第一组由 185 名患者组成，接受了 I/II 级腋窝淋巴结清扫术。第二组由 65 名患者组成，接受了积极的局部手术，其中 37 名患者进行了 I/II/III 级（锁骨下）解剖，28 名患者进行了 I/II/III 级 SLND。我们的研究评估了总生存期（OS）和无病生存期（DFS）作为主要终点，局部区域无复发生存期（LRRFS）和无远处转移生存期（DMFS）作为次要终点。结果：所有患者的中位随访时间为 5.92 年（1.05-15.36 年）。 5年OS率为71.89%，DFS率为59.25%，LRRFS率为66.38%，DMFS率为64.98%。第二组和第一组之间观察到 OS、DFS、LRRFS 和 DMFS 存在显着差异 (p < 0.01)。与 I/II/III 级解剖组相比，I/II/III 级 SLND 组没有观察到对复发、转移或生存结果的有益影响。多变量逻辑回归分析显示，I/II/III ± SLND 手术和 T 分期与 OS 相关（p = 0.006 和 p = 0.026），而 I/II/III ± SLND 手术、ER /HER2- 和组织学水平相关等级与 DFS 相关（p = 0.032、p = 0.001、p = 0.032）。结论：伴有 ISLNM 的乳腺癌可能被认为是一种局部区域疾病，需要全身治疗和局部治疗相结合。积极的局部手术已被证明可以对复发、转移和生存结果产生积极影响。这种方法可以改善乳腺癌患者 ISLNM 的管理。版权所有 © 2023 Feng、Xing、Dai、Cheng 和 Wang。

Background: Breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastases (ISLNM) have unfavorable prognoses. The role of supraclavicular lymph node dissection (SLND) as a surgical intervention in the treatment of this condition remains controversial. In this study, we aimed to evaluate the prognostic factors associated with breast cancer with ISLNM and to assess the potential impact of aggressive locoregional surgical management on patient outcomes. Methods: We conducted a retrospective analysis of 250 breast cancer patients with ISLNM who were treated with curative intent at our institution between 2000 and 2020. The cohort was stratified into groups based on the extent of axillary surgery. The first group, comprising 185 patients, underwent level I/II axillary dissection. The second group, consisting of 65 patients, underwent aggressive locoregional surgery, including levels I/II/III (infraclavicular) dissection in 37 patients and levels I/II/III + SLND in 28 patients. Our study evaluated overall survival (OS) and disease-free survival (DFS) as primary endpoints, and locoregional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS) as secondary endpoints. Results: The median follow-up time among all patients was 5.92 years (1.05-15.36 years). The 5-year OS rate was 71.89%, while the DFS rate, LRRFS rate, and DMFS rates were 59.25%, 66.38%, and 64.98%, respectively. A significant difference in OS, DFS, LRRFS, and DMFS was observed between the second group and the first group (p < 0.01). No beneficial impact on recurrence, metastasis, or survival outcomes was observed in the levels I/II/III + SLND group compared to the levels I/II/III dissection group. Multivariate logistic regression analysis revealed that levels I/II/III ± SLND surgery and T stage were associated with OS (p = 0.006 and p = 0.026), while levels I/II/III ± SLND surgery, ER+/HER2-, and histologic grade were associated with DFS (p = 0.032, p = 0.001, p = 0.032). Conclusion: Breast cancer with ISLNM may be considered a locoregional disease, requiring a combination of systemic and local therapies. Aggressive locoregional surgery has been shown to positively impact recurrence, metastasis, and survival outcomes. This approach may provide improved management of the ISLNM for breast cancer patients.Copyright © 2023 Feng, Xing, Dai, Cheng and Wang.