Regional Nodal Irradiation and Post-Mastectomy Radiation Therapy After Up-Front Surgery

Teresa P. Easwaran, Sara R. Alcorn, Jean L. Wright

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: This review serves to summarize available data impacting treatment decisions for the use of post-mastectomy radiation (PMRT) and regional nodal irradiation (RNI). Recent Findings: In the last decade, there have been ongoing shifts in breast cancer management, including changes in the type and sequencing of systemic therapy tailored to receptor subtype and molecular profiling, changes to the surgical management of the regional nodes, and improvements in radiation treatment planning and delivery technology. In this chapter, we will consider historic and modern indications for PMRT and RNI after up-front surgery and discuss how the changing paradigms of surgical and systemic management continue to impact the role of PMRT and RNI. Summary: The majority of patients with lymph node-positive breast cancer will have some benefit from PMRT and/or RNI, but in the modern era, the impact may be modest, particularly for patients with low-volume nodal involvement. Clinical trial enrollment, tailored recommendations, and shared decision making are important to optimize treatment decisions.

Original languageEnglish (US)
Pages (from-to)196-203
Number of pages8
JournalCurrent Breast Cancer Reports
Volume15
Issue number3
DOIs
StatePublished - Sep 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Hypofractionation
  • Internal mammary nodes (IMN)
  • Locoregional recurrence (LRR)
  • Patient-reported outcomes (PRO)
  • Post-mastectomy radiation therapy (PMRT)
  • Regional nodal irradiation (RNI)

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