POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS

1997 has been a turning point for the indication of post-mastectomy radiation therapy (PMRT). Two randomized studies from Denmark and British Columbia showed 9% absolute improvement in overall survival, in addition to local control with the use of PMRT in patients with tumors greater than 5 cm and/o...

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Main Author: Maktav Dinçer
Format: Article
Language:English
Published: Galenos Publishing House 2008-01-01
Series:European Journal of Breast Health
Subjects:
Online Access: http://www.eurjbreasthealth.com/archives/archive-detail/article-preview/post-mastectomy-adjuvant-radotherapy-contraversal-/42666
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author Maktav Dinçer
author_facet Maktav Dinçer
author_sort Maktav Dinçer
collection DOAJ
description 1997 has been a turning point for the indication of post-mastectomy radiation therapy (PMRT). Two randomized studies from Denmark and British Columbia showed 9% absolute improvement in overall survival, in addition to local control with the use of PMRT in patients with tumors greater than 5 cm and/or lymph node metastases. Several meta-analyses followed these publications all showing improvement in local control and indicating survival advantage with the use of radiotherapy in breast cancer. Contraversy was on the issue of whether radiotherapy should be used in all post-mastectomy patients or only on moderate to high (such as 10-20% or higher) local recurrence risk patients. Most consensus statements and all guidelines report that, high local recurrence risk patients, such as those with more than 4 involved nodes, T3N+, T4 or those with positive surgical margins are candidates for PMRT. T1/T2 N1-3+ patients are not in this category. However, in some analyses an improvement in local control and in survival with the use of radiotherapy has also been shown in patients with even one lymph node metastasis. This article will discuss the PMRT indication in 1-3 node positive patients. The reasons for these discussions are, the diffi culty of showing the benefi ts of radiotherapy in low risk patients and the wish of avoiding major radiation therapy related complications. One cruical issue in this indication is to use precise radiotherapy techniques in order to protect as much normal tissue as possible.
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spelling doaj.art-d30832c1a1c74d2f9e5fa7f089edbd622023-02-15T16:12:57ZengGalenos Publishing HouseEuropean Journal of Breast Health2587-08312008-01-014191413049054POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONSMaktav Dinçer0 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Radyasyon Onkolojisi Ab.D., İstanbul, Türkiye 1997 has been a turning point for the indication of post-mastectomy radiation therapy (PMRT). Two randomized studies from Denmark and British Columbia showed 9% absolute improvement in overall survival, in addition to local control with the use of PMRT in patients with tumors greater than 5 cm and/or lymph node metastases. Several meta-analyses followed these publications all showing improvement in local control and indicating survival advantage with the use of radiotherapy in breast cancer. Contraversy was on the issue of whether radiotherapy should be used in all post-mastectomy patients or only on moderate to high (such as 10-20% or higher) local recurrence risk patients. Most consensus statements and all guidelines report that, high local recurrence risk patients, such as those with more than 4 involved nodes, T3N+, T4 or those with positive surgical margins are candidates for PMRT. T1/T2 N1-3+ patients are not in this category. However, in some analyses an improvement in local control and in survival with the use of radiotherapy has also been shown in patients with even one lymph node metastasis. This article will discuss the PMRT indication in 1-3 node positive patients. The reasons for these discussions are, the diffi culty of showing the benefi ts of radiotherapy in low risk patients and the wish of avoiding major radiation therapy related complications. One cruical issue in this indication is to use precise radiotherapy techniques in order to protect as much normal tissue as possible. http://www.eurjbreasthealth.com/archives/archive-detail/article-preview/post-mastectomy-adjuvant-radotherapy-contraversal-/42666 post-mastectomy radiotherapybreast cancersurvival benefi ts of radiotherapy
spellingShingle Maktav Dinçer
POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS
European Journal of Breast Health
post-mastectomy radiotherapy
breast cancer
survival benefi ts of radiotherapy
title POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS
title_full POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS
title_fullStr POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS
title_full_unstemmed POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS
title_short POST-MASTECTOMY ADJUVANT RADIOTHERAPY: CONTRAVERSIAL INDICATIONS
title_sort post mastectomy adjuvant radiotherapy contraversial indications
topic post-mastectomy radiotherapy
breast cancer
survival benefi ts of radiotherapy
url http://www.eurjbreasthealth.com/archives/archive-detail/article-preview/post-mastectomy-adjuvant-radotherapy-contraversal-/42666
work_keys_str_mv AT maktavdincer postmastectomyadjuvantradiotherapycontraversialindications