Management of Carcinoma of Unknown Primary Involving Axillary Lymph Node (CUPAx)

Background: Cancer of unknown primary involving axillary lymph nodes(CUPAx) is a very rare type of cancer. There are still many challenges about themanagement and outcome of the disease. This retrospective study is an attempt toassess the overall survival and the outcome of CUPAx in Iranian women. Methods: Based on inclusion and exclusion criteria, ۲۰ patients primarilydiagnosed with CUPAx referred to our breast multidisciplinary team (MDT)sessions between July ۲۰۱۰ and December ۲۰۱۶ were evaluated. The patients werecategorized into three groups based on the types of treatment: mastectomy andradiation therapy, radiation therapy, and observation group. Results: The mean age of the subjects was ۵۲ ± ۷.۹۱ years (range: ۴۲-۷۴). Theresults manifested significant differences between the outcomes of three types oftreatments. The patients who received both mastectomy and radiotherapy had ahigher survival rate and no sign of the disease compared with other groups (P=۰.۰۳). The median survival time in the mastectomy group was ۷۸ months and ۲۳months for the group with no mastectomy (۹۵% CI: ۷.۶۴-۳۸.۳۶) (P <۰.۰۰۱). Conclusion: The result suggested that mastectomy was effective in loweringthe risk of disease progression in Iranian women diagnosed with CUPAx andhighly suspicious breast origin. More studies on larger sample groups are needed.

Keywords:

Unknown primary tumors , lymph nodes , axilla