Dr. Freedman on the NCCN Guidelines for Post-Mastectomy Radiation

Laura M. Freedman, MD
Published: Friday, Mar 16, 2018



Laura M. Freedman, MD, assistant professor, director of Radiation Oncology, Sylvester Comprehensive Cancer Center, discusses the revised National Comprehensive Cancer Network (NCCN) guidelines for post-mastectomy radiation given in women who have pathologic T1 and T2 tumors and 1 to 3 positive lymph nodes.

It is known that patients with no lymph nodes involved do not derive a benefit from post-mastectomy radiation, although there are exceptions. For example, high-risk patients and those with positive margins and early-stage tumors, typically do not show additional benefit post-mastectomy.

For patients with 4 or more positive nodes, the addition of radiation provides a positive benefit in terms of local recurrence and overall survival. The data on patients with 1 to 3 positive lymph nodes has been more difficult to obtain. The NCCN guidelines will help streamline the use of radiation in what tends to be a more heterogeneous group of patients, explains Freedman.
 


Laura M. Freedman, MD, assistant professor, director of Radiation Oncology, Sylvester Comprehensive Cancer Center, discusses the revised National Comprehensive Cancer Network (NCCN) guidelines for post-mastectomy radiation given in women who have pathologic T1 and T2 tumors and 1 to 3 positive lymph nodes.

It is known that patients with no lymph nodes involved do not derive a benefit from post-mastectomy radiation, although there are exceptions. For example, high-risk patients and those with positive margins and early-stage tumors, typically do not show additional benefit post-mastectomy.

For patients with 4 or more positive nodes, the addition of radiation provides a positive benefit in terms of local recurrence and overall survival. The data on patients with 1 to 3 positive lymph nodes has been more difficult to obtain. The NCCN guidelines will help streamline the use of radiation in what tends to be a more heterogeneous group of patients, explains Freedman.
 

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