Effective and safe regional node irradiation in early breast cancer

Postoperative radiation therapy has been a mainstay of treatment for early breast cancer for many years. The efficacy of chest wall radiation therapy after mastectomy and whole breast irradiation after breast conserving surgery was established through randomised controlled trials. 1 Early Breast Cancer Trialists' Collaborative GroupEffects of radiotherapy and surgery in early breast cancer. An overview of the randomized trials. N Engl J Med. 1995; 333: 1444-1455 Crossref PubMed Scopus (1054) Google Scholar , 2 Clarke M Collins R Darby S et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005; 366: 2087-2106 Summary Full Text Full Text PDF PubMed Scopus (4223) Google Scholar , 3 Darby S McGale P Correa C et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials. Lancet. 2011; 378: 1707-1716 Summary Full Text Full Text PDF PubMed Scopus (2799) Google Scholar In some of these trials, regional nodes were irradiated, but it is unclear how much of the effect of the radiation therapy occurred because of regional nodal irradiation. Radiotherapy to regional nodes in early breast cancer: an individual patient data meta-analysis of 14 324 women in 16 trialsRegional node radiotherapy significantly reduced breast cancer mortality and all-cause mortality in trials done after the 1980s, but not in older trials. These contrasting findings could reflect radiotherapy improvements since the 1980s. Full-Text PDF Open Access