Long-Term Survival of Patients With Supraclavicular Metastases at Diagnosis of Breast Cancer
Bibliographic record
Abstract
BACKGROUND: Patients with supraclavicular metastases at diagnosis of breast cancer were classified between 1987 and 2002 as having stage M(1) breast cancer according to the tumor-node-metastasis (TNM) system. The 2003 edition of the TNM staging guidelines has classified such patients as having stage IIIC disease. To determine relative prognosis, we compared long-term survival in a population-based cohort of patients with isolated supraclavicular metastases (nodal-M(1)) to outcomes of patients with stage IIIB or M(1) (other) disease at presentation. MATERIALS AND METHODS: Among patients with breast cancer and known tumor stage referred to the British Columbia Cancer Agency from 1976 to 1985, 336 IIIB, 233 M(1), and 51 nodal-M(1) patients were identified. Actuarial overall and breast cancer-specific survival rates were determined to 20 years. RESULTS: Overall survival at 20 years was 13.2% for nodal-M(1) cases (95% confidence interval [CI], 5% to 26%), 9.4% for IIIB cases (95% CI, 6% to 14%), and 1.3% for M(1) (other) cases (95% CI, 0.4% to 3.5%; log-rank P <.0005). Overall survival was similar between nodal-M(1) and IIIB cases (P =.27). Breast cancer-specific survival at 20 years was 24.1% for nodal-M(1) cases (95% CI, 13% to 37%), 30.2% for IIIB cases (95% CI, 23% to 38%), and 3.9% for M(1) (other) cases (95% CI, 2% to 8%; log-rank P <.0005). Breast cancer-specific survival was significantly different for nodal-M(1) cases compared with either IIIB or M(1) (other) cases (P =.008 for both). CONCLUSION: Patients with supraclavicular metastases at diagnosis have significantly better outcomes than patients with M(1) (other) disease and overall survival similar to patients with IIIB disease. Reclassification as stage IIIC is appropriate for patients with breast cancer who present with supraclavicular nodal metastases alone.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".