Radiotherapy of the Lymphatic Pathways in Early Breast Cancer
Identifieur interne : 000F32 ( Pmc/Checkpoint ); précédent : 000F31; suivant : 000F33Radiotherapy of the Lymphatic Pathways in Early Breast Cancer
Auteurs : Marie-Luise Sautter-Bihl [Allemagne] ; Felix Sedlmayer [Autriche]Source :
- Breast Care [ 1661-3791 ] ; 2015.
Abstract
International guidelines reveal substantial differences regarding indications for regional nodal irradiation (RNI). Recently, several randomized studies provided new insights and these are discussed here. Patients with 1-3 positive nodes seem to profit from RNI compared to whole-breast (WBI) or chest-wall irradiation (CWI) alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and 1 meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel nodes or microscopic metastases on prognosis are equivocal. Recent data suggest that the current restrictive use of RNI should be scrutinized, as the hazard-benefit relation appears to shift towards an improvement of outcome.
Url:
DOI: 10.1159/000438662
PubMed: 26600761
PubMed Central: 4608631
Affiliations:
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PMC:4608631Le document en format XML
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<author><name sortKey="Sautter Bihl, Marie Luise" sort="Sautter Bihl, Marie Luise" uniqKey="Sautter Bihl M" first="Marie-Luise" last="Sautter-Bihl">Marie-Luise Sautter-Bihl</name>
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<series><title level="j">Breast Care</title>
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<front><div type="abstract" xml:lang="en"><title>Summary</title>
<p>International guidelines reveal substantial differences regarding indications for regional nodal irradiation (RNI). Recently, several randomized studies provided new insights and these are discussed here. Patients with 1-3 positive nodes seem to profit from RNI compared to whole-breast (WBI) or chest-wall irradiation (CWI) alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and 1 meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel nodes or microscopic metastases on prognosis are equivocal. Recent data suggest that the current restrictive use of RNI should be scrutinized, as the hazard-benefit relation appears to shift towards an improvement of outcome.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Breast Care (Basel)</journal-id>
<journal-id journal-id-type="iso-abbrev">Breast Care (Basel)</journal-id>
<journal-id journal-id-type="publisher-id">BRC</journal-id>
<journal-title-group><journal-title>Breast Care</journal-title>
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<issn pub-type="ppub">1661-3791</issn>
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<publisher><publisher-name>S. Karger AG</publisher-name>
<publisher-loc>Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch</publisher-loc>
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<title-group><article-title>Radiotherapy of the Lymphatic Pathways in Early Breast Cancer</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Sautter-Bihl</surname>
<given-names>Marie-Luise</given-names>
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<xref ref-type="aff" rid="aff1">a</xref>
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<aff id="aff1"><sup>a</sup>
Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe, Germany</aff>
<aff id="aff2"><sup>b</sup>
Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Salzburg, Austria</aff>
<author-notes><corresp id="cor1">*Prof. Dr. med. Marie-Luise Sautter-Bihl, Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe, Moltkestraße 90, 76133 Karlsruhe, Germany, <email>Marie-Luise.Sautter-Bihl@klinikum-karlsruhe.de</email>
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<pub-date pub-type="ppub"><month>8</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>19</day>
<month>8</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>8</month>
<year>2016</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and
0 days and was based on the . </pmc-comment>
<volume>10</volume>
<issue>4</issue>
<fpage>254</fpage>
<lpage>258</lpage>
<permissions><copyright-statement>Copyright © 2015 by S. Karger AG, Basel</copyright-statement>
<copyright-year>2015</copyright-year>
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<abstract><title>Summary</title>
<p>International guidelines reveal substantial differences regarding indications for regional nodal irradiation (RNI). Recently, several randomized studies provided new insights and these are discussed here. Patients with 1-3 positive nodes seem to profit from RNI compared to whole-breast (WBI) or chest-wall irradiation (CWI) alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and 1 meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel nodes or microscopic metastases on prognosis are equivocal. Recent data suggest that the current restrictive use of RNI should be scrutinized, as the hazard-benefit relation appears to shift towards an improvement of outcome.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Breast cancer</kwd>
<kwd>Radiotherapy</kwd>
<kwd>Regional nodal irradiation</kwd>
</kwd-group>
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<page-count count="5"></page-count>
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