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Title: Nodal Radiation May Be Unnecessary After Mastectomy: Presented at ASTRO
URL: http://www.pslgroup.com/dg/22D7CA.htm
Doctor's Guide
September 25, 2008

By Martha Kerr

BOSTON -- September 25, 2008 -- Radiation of the axillary and supraclavicular nodes may not be medically necessary and its toxicity may be avoided, according to a study presented here at the American Society for Therapeutic Radiology and Oncology (ASTRO) 50th Annual Meeting.

Penny Anderson, MD, Radiation Oncology Department, Fox Chase Cancer Center, Philadelphia, Pennsylvania, presented the research findings on the need for postmastectomy radiation in 64 patients with pathology-confirmed, node-negative breast cancer, who were treated by mastectomy and radiation between 1985 and 2006.

Patients were a median of 52 years old; 35 patients had stage T1 or T2 node-negative disease and 29 patients had stage T3 node-negative disease. They were followed for a median of 78 months.

There were 53 patients who received radiation therapy to the chest wall only and 11 patients who received radiation to the chest wall and lymph nodes. Nine of the 11 received radiation to the supraclavicular region only and 2 also received an axillary boost. Median radiation dose was 50 Gy to the chest wall and 46 Gy to the lymph nodes.

The researchers found "an extremely low rate of regional nodal failure in patients with pathologically node-negative breast tumours following complete dissection that are greater than 5 cm or have close-to-positive margins following mastectomy and adjuvant radiotherapy to the chest wall alone," Dr. Anderson said in a presentation on September 23.

At follow-up, "we found an extremely low rate of recurrences in the lymph nodes among those who didn't have them irradiated," Dr. Anderson said.

One of the 53 women who received chest-wall radiation alone developed a recurrence in an axillary lymph node. None of the patients who received chest wall and node radiation had a recurrence.

The 5-year overall survival rates were 91% among women who received radiation to the chest wall only and 100% for those who received radiation to both the chest wall and lymph nodes.

There was no statistically significant difference noted between the local, regional or distant recurrence rates between the 2 groups.


[Presentation title: Post-Mastectomy Radiation for Node-Negative Breast Cancer: Is Regional Node Coverage Always Needed? Poster 2057]

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