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 the management and outcome of the disease. This retrospective study is an attempt to assess the overall survival and the outcome of CUPAx in Iranian women. Methods: Based on inclusion and exclusion criteria, 20 patients primarily diagnosed with CUPAx referred to our breast multidisciplinary team (MDT) sessions between July 2010 and December 2016 were evaluated. The patients were categorized into three groups based on the types of treatment: mastectomy and radiation therapy, radiation therapy, and observation group. Results: The mean age of the subjects was 52 ± 7.91 years (range: 42-74). The results manifested significant differences between the outcomes of three types of treatments. The patients who received both mastectomy and radiotherapy had a higher survival rate and no sign of the disease compared with other groups (P= 0.03). The median survival time in the mastectomy group was 78 months and 23 months for the group with no mastectomy (95% CI: 7.64-38.36) (P <0.001). Conclusion: The result suggested that mastectomy was effective in lowering the risk of disease progression in Iranian women diagnosed with CUPAx and highly suspicious breast origin. More studies on larger sample groups are needed.