LAUSR

Contralateral axillary lymph node metastasis (CAM) is a rare clinical entity with a reported incidence of between 1.9 and 6%. Its origin may be related to the source of metastatic disease; as contralateral dissemination from primary breast cancer diagnosed during follow-up, for many years CAM has represented a debatable issue in breast cancer management, with unsure prognostic impact. It occurs after local treatment for breast cancer, in particular surgery and radiotherapy (RT), with metachronous or synchronous clinical detection. Traditionally, contralateral lymph nodes were considered a distant site and CAM was consequently classified as advanced breast cancer; therefore, CAM tended to be preferentially liable to palliative treatment. Likewise, in this context, prior to the 6th edition of the American Joint Commission on Cancer (AJCC) staging manual, ipsilateral supraclavicular lymph node metastasis in breast cancer patients without distant metastases was defined as M1 disease (stage IV).