Regional Nodal Irradiation for Early-Stage Breast Cancer

Two landmark trials — EORTC 22922/10925 and MA.20 — show an advantage for distant disease-free survival with RNI but no benefit for overall survival, the primary endpoint.

The potential survival advantage of regional nodal irradiation (RNI) in high-risk and node-positive early breast cancer is controversial in the modern era of effective adjuvant therapies and a greater understanding of molecular subtypes. Now, investigators have conducted two trials to address this issue.

In the EORTC 22922/10925 study by Poortmans and colleagues, 4004 patients were randomized to whole-breast or chest-wall radiotherapy with RNI (supraclavicular and internal mammary radiotherapy) versus without RNI (controls) from 1996 to 2004. Of these patients, 76% had breast-conserving surgery, 24% had mastectomy, 44% were node-negative, 96% had tumor size <5 cm, 43% had one to three positive nodes, 25% received adjuvant chemotherapy, 30% r…

Reviewing Author

Henry Mark Kuerer, MD, PhD, FACS

Disclosures

Speaker's BureauPhysicians’ Education Resource, LLC

RoyaltiesMcGraw-Hill Professional; UpToDate, Inc.

Editorial BoardsAnnals of Surgical Oncology

Leadership Positions in Professional SocietiesAmerican Society of Breast Surgeons (Chair, Publications Committee)