RADIOTHERAPY IN BREAST CANCER

In Breast Conserving Surgery patients;

After breast-conserving surgery (BCS), a particularly common site of local recurrence is the conserved breast itself (or the axilla, if this has not been treated effectively). The risk of recurrence in a conserved breast can be substantial even in node-negative disease that has
been confirmed by axillary clearance, and it can be greatly reduced by radiotherapy. Hence, the recent National Institutes of Health (NIH) consensus conference on early breast cancer recommended that after BCS there should be radiotherapy to the conserved breast.


Post-mastectomy radiotherapy:

Even after mastectomy, an appreciable risk of local recurrence (eg, in the chest wall or lymph nodes) can remain unless some reliable method of investigation, such as axillary clearance, has found no evidence of nodal involvement. If axillary investigation reveals nodal involvement (or if the axilla has not been adequately investigated), post-mastectomy radiotherapy can produce
a substantial absolute reduction in this risk of local recurrence, and previous trials and meta-analyses have shown that although it has little effect on breast cancer mortality during the first few years, it can produce a moderate, but definite, reduction in longer-term breast
cancer mortality. Hence, the NIH consensus conference recommended radiotherapy after mastectomy for women at high risk of locoregional recurrence (eg, those with four or more involved lymph nodes).
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