Commentary

The 2000 NIH Consensus Conference and the NCCN guidelines indicate that postmastectomy radiation therapy is standard for women with four or more positive axillary lymph nodes. A small but significant fraction of physicians do not follow this practice, and many respondents indicate that they recommend radiation therapy for women with three positive nodes. Age does not seem to be an important factor in this decision. Patients with one to three positive nodes are currently being studied in a large Intergroup randomized clinical trial.

Select publications

Arriagada R. Radiotherapy for breast cancer. N Engl J Med 2002;346(11):862-4. Abstract

Hurkmans CW et al. Reduction of cardiac and lung complication probabilities after breast irradiation using conformal radiotherapy with or without intensity modulation. Radiother Oncol 2002;62(2):163-71. Abstract

Pierce LJ. Treatment guidelines and techniques in delivery of postmastectomy radiotherapy in management of operable breast cancer. J Natl Cancer Inst Monogr 2001;30:117-124. Abstract

Recht A et al. Postmastectomy radiotherapy: Clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 2001;19(5):1539-69. Abstract

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