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26-07-2023 | Mastectomy | ASO Author Reflections

ASO Author Reflections: The Case for Using Response to Neoadjuvant Chemotherapy to Guide Administration of Post-mastectomy Radiation

Authors: Ritika Manik, BS, Oluwadamilola M. Fayanju, MD, MA, MPHS

Published in: Annals of Surgical Oncology | Issue 11/2023

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Excerpt

Patients with clinical T3 breast cancer (tumors  > 5 cm in diameter) may benefit from post-mastectomy radiation therapy (PMRT) via concomitantly reduced locoregional recurrence and potentially increased overall survival (OS).1 However, the benefits are less clear for patients presenting with locally advanced disease and no nodal involvement (cN0) or with limited nodal involvement (cN1) that responds to neoadjuvant chemotherapy (NACT). Given the potential morbidity associated with radiotherapy (e.g., lymphedema, cardiotoxicity), it is important to balance the ratio of risks to benefits, but striking this balance is difficult in light of conflicting research findings and non-alignment between clinical guidelines and clinical practice for cT3 patients.2
Literature
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go back to reference Mamounas EP, Bandos H, White JR, Julian TB, Khan AJ, Shaitelman SF, Torres M Ann, Vicini Frank, Ganz PA, McCloskey SA, Paik S, Nilendu Gupta X, Li A, DiCostanzo DJ, Curran WJ, Wolmark N. NRG Oncology/NSABP B-51/RTOG 1304: phase III trial to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to whole breast RT post breast-conserving surgery (BCS) reduces invasive breast cancer recurrence-free interval (IBCR-FI) in patients (pts) with pathologically positive axillary (PPAx) nodes who are ypN0 after neoadjuvant chemotherapy (NC). J Clin Oncol. 2019;37(15_suppl):TPS600–TPS600. https://doi.org/10.1200/JCO.2019.37.15_suppl.TPS600.CrossRef Mamounas EP, Bandos H, White JR, Julian TB, Khan AJ, Shaitelman SF, Torres M Ann, Vicini Frank, Ganz PA, McCloskey SA, Paik S, Nilendu Gupta X, Li A, DiCostanzo DJ, Curran WJ, Wolmark N. NRG Oncology/NSABP B-51/RTOG 1304: phase III trial to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to whole breast RT post breast-conserving surgery (BCS) reduces invasive breast cancer recurrence-free interval (IBCR-FI) in patients (pts) with pathologically positive axillary (PPAx) nodes who are ypN0 after neoadjuvant chemotherapy (NC). J Clin Oncol. 2019;37(15_suppl):TPS600–TPS600. https://​doi.​org/​10.​1200/​JCO.​2019.​37.​15_​suppl.​TPS600.CrossRef
Metadata
Title
ASO Author Reflections: The Case for Using Response to Neoadjuvant Chemotherapy to Guide Administration of Post-mastectomy Radiation
Authors
Ritika Manik, BS
Oluwadamilola M. Fayanju, MD, MA, MPHS
Publication date
26-07-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 11/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-13923-4

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