Radiotherapy to the internal mammary nodes (IMNs) is among the most controversial and polarizing issues in radiation oncology, owing to conflicting data and the need to delineate a balance between potential outcome benefits and cardiopulmonary toxic effects. Though occult IMN involvement is higher in patients with tumors larger than 2 cm, younger women, and patients with axillary metastases, previous randomized clinical trials (RCTs) of mastectomy (without radiation and/or systemic therapies) failed to demonstrate survival benefits with IMN dissection.1 With the recent publication of 2 large RCTs of regional nodal irradiation (RNI) therapy, the status of this debate becomes murkier.
Verma V, Beriwal S. Internal Mammary Node Radiation in Light of the EORTC 22922 and MA.20 Trials—What Have We Really Learned? JAMA Oncol. 2016;2(8):992–993. doi:10.1001/jamaoncol.2015.5810
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.