The effect of regional nodal irradiation after surgery in breast cancer patients

Poortman, Philip.jpg

A large international study of over 4,000 patients with breast cancer (stage1-3) shows that regional radiation therapy after surgery improves survival. The results of the study, coordinated by Professor of Radiation Oncology Philip Poortmans of the Radboudumc, have been recently published in the New England Journal of Medicine (NEJM).

Metastasis of cancer often takes place via the lymph nodes.  Until the late 1980s it was quite common to irradiate the breast or chest wall and all the surrounding glandular areas after surgery in order to clean up any remaining tumor cells. That approach became less popular after some studies showed that particularly irradiation of the internal mammary lymph node region could possibly cause damage to the heart, without clear evidence of the benefit of specifically these lymph nodes. But in the mid-nineties a number of positive messages appeared, which were associated with a more targeted radiation and a better shielding of the heart. Philip Poortmans: "For us this was the signal to start in thirteen countries with 46 hospitals a new trial to gain more clarity in this controversy. In other words, does the irradiation of the lymph nodes surrounding the breast/chest wall make sense? The NEJM now publishes the 10-year results of this long-term study."


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