Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

The Role of Adjuvant Radiotherapy in the Treatment of Breast Cancer

Iveta Kolářová
,
Bohuslav Melichar
,
Igor Sirák
* ORCID logo ,
Jaroslav Vaňásek
,
Jiří Petera
,
Kateřina Horáčková
,
Denisa Pohanková
,
Filip Ďatelinka
,
Zuzana Šinkorová
,
Milan Vošmik
ORCID logo
Version 1 : Received: 17 January 2024 / Approved: 17 January 2024 / Online: 18 January 2024 (09:50:02 CET)

A peer-reviewed article of this Preprint also exists.

Kolářová, I.; Melichar, B.; Sirák, I.; Vaňásek, J.; Petera, J.; Horáčková, K.; Pohanková, D.; Ďatelinka, F.; Šinkorová, Z.; Vošmik, M. The Role of Adjuvant Radiotherapy in the Treatment of Breast Cancer. Curr. Oncol. 2024, 31, 1207-1220. Kolářová, I.; Melichar, B.; Sirák, I.; Vaňásek, J.; Petera, J.; Horáčková, K.; Pohanková, D.; Ďatelinka, F.; Šinkorová, Z.; Vošmik, M. The Role of Adjuvant Radiotherapy in the Treatment of Breast Cancer. Curr. Oncol. 2024, 31, 1207-1220.

Abstract

The role of postmastectomy radiotherapy and regional nodal irradiation after radical mastectomy is defined in high-risk patients with locally advanced tumors, positive margins, and unfavorable biology. The benefit of postmastectomy radiotherapy in intermediate-risk patients (T3N0 tumors) remains a matter of controversy. It has been demonstrated that radiotherapy after breast-conserving surgery lowers the locoregional recurrence rate compared with surgery alone and improves the overall survival rate. In patients with 4 or more positive lymph nodes or extracapsular extension regional lymph node irradiation is indicated regardless of the surgery type (breast-conserving surgery or mastectomy). Despite the consensus that patients with more than 3 positive lymph nodes should be treated with radiotherapy, there is a controversy regarding the recommendations for patients with one to three involved lymph nodes. In patients with N0 disease with negative findings on axillary surgery, there is a trend to administer regional lymph node irradiation in patients with a high risk of recurrence. In patients treated with neoadjuvant systemic therapy and mastectomy, adjuvant radiotherapy should be administered in case of clinical stage III and/or ≥ypN1. In patients treated with neoadjuvant systemic therapy and breast-conserving surgery, postoperative radiotherapy is indicated irrespective of pathological response.

Keywords

breast cancer; adjuvant radiotherapy; whole breast irradiation; mastectomy; breast conserving surgery; regional node irradiation; neoadjuvant chemotherapy

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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