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Postmastectomy radiation therapy reduces local recurrence risk and prolongs survival in patients at high risk for breast cancer recurrence, including those with a high nodal burden, but what about in patients at intermediate risk for recurrence? To address this, investigators conducted an international, phase 3, randomized trial (SUPREMO) comparing chest-wall radiation with no radiation therapy among 1600 women who had undergone mastectomy for intermediate-risk breast cancer.
Approximately 30% of the women had stage T1N1 disease; 25% had T2N0 disease with grade 3 histology, lymphovascular invasion, or both; and 45% had T2N1 disease. Roughly 85% received chemotherapy (which consisted of anthracycline-based regimens, with or without a t…