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Abstract
PURPOSE:
We conducted this study to investigate the prognosis and failure pattern after breast-conserving treatment (BCT) in patients with occult breast cancer (OBC) with negative breast magnetic resonance imaging (MRI) (MRI-OBC).

MATERIALS AND METHODS:
Survival rates and failure patterns in 66 patients who received axillary lymph node dissection (ALND) and BCT for MRI-OBC between 2001 and 2013 at seven hospitals were analyzed. OBC was defined as adenocarcinoma in the axillary lymph node (ALN) +/- supraclavicular (SCN) or internal mammary lymph node (IMN) with a negative breast MRI.

RESULTS:
Fifty-four patients had only ALN metastasis (ALN only), and 12 patients had ALN metastasis along with SCN or IMN metastasis (ALN + SCN/IMN). Median follow-up was 82 months. The 5-year overall, disease-free, and breast cancer-free survival rates were 93.4%, 92.1%, and 96.8%, respectively. Nine patients experienced recurrence: breast (n = 4), regional lymph nodes (RLN, n = 1), distant metastases (DM, n = 2), breast/RLN (n = 1), and breast/RLN/DM (n = 1). Five-year disease-free survival was significantly higher in ALN only patients compared to ALN + SCN/IMN patients (96.1% vs. 75.0%; p = 0.02).

CONCLUSIONS:
Patients with MRI-OBC were successfully treated with BCT. There was a small risk of ipsilateral breast cancer recurrence. Failure patterns depended on the extent of initial disease.

Author information

Kim H1, Park W2, Kim SS3, Ahn SJ4, Kim YB5, Kim TH6, Kim JH7, Choi JH8, Park HJ9, Chang JS5, Choi DH1.
1
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
2
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: wonro.park@samsung.com.
3
Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: watermountain@hanmail.net.
4
Chonnam National University Medical School, Gwangju, South Korea.
5
Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
6
Research Institute and Hospital, National Cancer Center, Goyang, South Korea.
7
Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
8
Chung-Ang University Hospital, China.
9
Hanyang University College of Medicine, Seoul, South Korea.