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Clinical Practice Guidelines For The Care And Treatment Of Breast Cancer: 16. Locoregional Post-mastectomy Radiotherapy
P. Truong, I. Olivotto, T. Whelan, M. Levine
Published 2004 · Medicine
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Objective: To provide information and recommendations to assist women with breast cancer and their physicians in making decisions regarding the use of locoregional post-mastectomy radiotherapy (PMRT). Outcomes: Locoregional control, disease-free survival, overall survival and treatment-related toxicities. Evidence: This guideline is based on a review of all meta-analyses, consensus statements and other guidelines published between 1966 and November 2002. Searches of MEDLINE and CANCERLIT for English-language randomized controlled trials published between 1995 and November 2002 were also conducted to supplement the literature previously reviewed by the American Society of Clinical Oncology (ASCO) Health Services Research Committee panel in its published guideline. A nonsystematic review of the literature was continued through June 2003. Recommendations: Locoregional PMRT is recommended for women with an advanced primary tumour (tumour size 5 cm or greater, or tumour invasion of the skin, pectoral muscle or chest wall). Locoregional PMRT is recommended for women with 4 or more positive axillary lymph nodes. The role of PMRT in women with 1 to 3 positive axillary lymph nodes is unclear. These women should be offered the opportunity to participate in clinical trials of PMRT. Locoregional PMRT is generally not recommended for women who have tumours that are less than 5 cm in diameter and who have negative axillary nodes. Other patient, tumour and treatment characteristics, including age, histologic grade, lymphovascular invasion, hormone receptor status, number of axillary nodes removed, axillary extracapsular extension and surgical margin status, may affect locoregional control, but their use in specifying additional indications for PMRT is currently unclear. PMRT should encompass the chest wall and the supraclavicular, infraclavicular and axillary apical lymph node areas. To reduce the risk of lymphedema, radiation of the entire axilla should not be used routinely after complete axillary dissection of level I and II lymph nodes. A definite recommendation regarding the inclusion of the internal mammary lymph nodes in PMRT cannot be made because of limited and inconsistent data. The use of modern techniques in radiotherapy planning is recommended to minimize excessive normal tissue exposure, particularly to the cardiac and pulmonary structures. Common short-term side effects of PMRT, including fatigue and skin erythema, are generally tolerable and not dose-limiting. Severe long-term side effects, including lymphedema, cardiac and pulmonary toxicities, brachial plexopathy, rib fractures and secondary neoplasms, are relatively rare. The optimal sequencing of PMRT and systemic therapy is currently unclear. Regimens containing anthracyclines or taxanes should not be administered concurrently with radiotherapy because of the potential for increased toxicity. Validation: The authors' original text was submitted for review, revision and approval by the Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. Subsequently, feedback was provided by 11 oncologists from across Canada. The final document was approved by the steering committee. Sponsor: The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer was convened by Health Canada. Completion date: November 2003.
This paper references
An interim analysis of the randomized surgical adjuvant trial for patients with unfavorable breast cancer
A. Martinez (1984)
Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial
M. Overgaard (1999)
Long-term cardiac morbidity and mortality in a randomized trial of pre- and postoperative radiation therapy versus surgery alone in primary breast cancer.
G. Gyenes (1998)
Cardiovascular mortality in a randomized trial of adjuvant radiation therapy versus surgery alone in primary breast cancer.
L. Rutqvist (1992)
Local recurrence after simple mastectomy
S. O'Rourke (1994)
Risk of internal mammary lymph node metastases and its prognostic value in breast cancer patients
M. Noguchi (1993)
Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial.
M. Overgaard (1997)
Risk of pneumonitis in breast cancer patients treated with radiation therapy and combination chemotherapy with paclitaxel.
A. Taghian (2001)
Treatment-related toxicity from a randomized trial of the sequencing of doxorubicin and radiation therapy in patients treated for early stage breast cancer.
P. Hardenbergh (1999)
Does locoregional radiotherapy improve survival in breast cancer? A meta-analysis
TJ Whelan (2000)
National Institutes of Health Consensus Development Conference statement: adjuvant therapy for breast cancer, November 1-3, 2000.
P. Eifel (2001)
Local recurrence and the deep resection Locoregional post-mastectomy radiotherapy
SJ Mentzer (2004)
juvant chemotherapy and radiation therapy vs . chemotherapy alone for stage II breast cancer patients . A national randomized trial [ abstract ]
H Gervasio (1990)
A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger.
G. Freedman (1998)
The results of radiation therapy for isolated local regional recurrences after mastectomy
F Schwaibold (1991)
National Institutes of Health Consensus Development Statement: adjuvant therapy for breast
P Eifel (2000)
Frequency, sites of relapse, and outcome of regional node failures following conservative surgery and radiation for early breast cancer.
B. Fowble (1989)
Phase III study: adjuvant chemotherapy versus radiotherapy plus chemotherapy in women with node-positive breast cancer. A retrospective analysis of 18 years
Radiation pneumonitis in breast cancer patients treated with conservative surgery and radiation therapy.
T. Lingos (1991)
Significance of internal mammary lymph node metastases in breast cancer.
J. Urban (1971)
The total incidence of loco-regional recurrence in a randomized trial of breast cancer TNM stage II. The South Sweden Breast Cancer Trial.
L. Tennvall-Nittby (1993)
Effects of radiotherapy and surgery in early breast cancer. An overview of the randomized trials.
A. Howell (1995)
Risk of leukemia after chemotherapy and radiation treatment for breast cancer.
R. Curtis (1992)
Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials
J. Vermorken (2000)
Risk of lymphoedema following the treatment of breast cancer
M. W. Kissin (1986)
Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology.
A. Recht (2001)
Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer.
J. Cuzick (1988)
Long-term effects of adjuvant tamoxifen and/or radiotherapy. The South Sweden Breast Cancer Trial.
S. Rydén (1992)
Radical mastectomy versus radical mastectomy plus internal mammary dissection. Ten year results of an international cooperative trial in breast cancer.
J. Lacour (1983)
Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer.
J. Ragaz (1997)
Systemic treatment of early breast-cancer by hormonal, cytotoxic, or immune therapy: 133 randomized trials involving 31000 recurrences and 24000 deaths among 75000 women: 1
A. D. Schryver (1992)
Polychemotherapy for early breast cancer: an overview of the randomised trials
M. Clarke (1998)
Are axillary recurrence and overall survival affected by axillary extranodal tumor extension in breast cancer? Implications for radiation therapy.
C. Leonard (1995)
Clinical practice guidelines for the care and treatment of breast cancer: adjuvant systemic therapy for node-positive breast cancer (summary of the 2001 update). The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer.
M. Levine (2001)
Adjuvant treatment of postmenopausal patients with high risk primary breast cancer. Results from the Danish adjuvant trials DBCG 77 C and DBCG 82 C.
H. Mouridsen (1988)
Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy.
J. Cuzick (1994)
Extracapsular axillary node extension in patients receiving adjuvant systemic therapy: an indication for radiotherapy?
B. Fisher (1997)
Adjuvant chemotherapy and radiation therapy vs. chemotherapy alone for stage II breast cancer patients. A national randomized trial [abstract
H Hayat (1990)
College of Family Physicians of Canada.
R. Krause (1983)
The role of radiotherapy in the management of operable locally advanced breast carcinoma: results of a randomized trial by the Eastern Cooperative Oncology Group. Cancer 1997;79:1138-49
JE Olson (1997)
Axillary dissection of level I and II lymph nodes is important in breast cancer classification. The Danish Breast Cancer Cooperative Group (DBCG).
C. Axelsson (1992)
A preliminary assessment of factors associated with recurrent disease in a surgical adjuvant clinical trial for patients with breast cancer with special emphasis on the aggressiveness of therapy
D. Ahmann (1982)
Prognosis of Breast Cancer Patients after Mastectomy and Dissection of Internal Mammary Nodes
U. Veronesi (1985)
The role of radiotherapy in the management of operable locally advanced breast carcinoma
J. Olson (1997)
The 5-year results of a randomized trial of adjuvant radiation therapy after chemotherapy in breast cancer patients treated with mastectomy.
K. Griem (1987)
Postmastectomy radiotherapy: guidelines of the American Society of Clinical Oncology
A Recht (2001)
Postoperative radiotherapy following mastectomy for high-risk breast cancer. A randomised trial.
D. A. Morgan (2002)
Microscopic extracapsular extension in the axilla: is this an indication for axillary radiotherapy?
L. Pierce (1995)
Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone.
I. Højris (2000)
Morbidity and mortality of ischaemic heart disease in high-risk breast-cancer patients after adjuvant postmastectomy systemic treatment with or without radiotherapy: analysis of DBCG 82b and 82c randomised trials
I. Højris (1999)
Tamoxifen for early breast cancer: An overview of the randomised trials
O. Abe (1998)
Assessment of coronary heart disease morbidity and mortality after radiation therapy for early breast cancer.
K. Vallis (2002)
Mortality from myocardial infarction after adjuvant radiotherapy for breast cancer in the surveillance, epidemiology, and end-results cancer registries.
L. Paszat (1998)
Postmastectomy radiotherapy: questions for the twenty-first century.
A. Recht (1998)
Locoregional recurrence patterns after mastectomy and doxorubicin-based chemotherapy: implications for postoperative irradiation.
A. Katz (2000)
Long-term cardiac sequelae in operable breast cancer patients given adjuvant chemotherapy with or without doxorubicin and breast irradiation.
M. Zambetti (2001)
Postsurgical adjuvant chemotherapy with or without radiotherapy in women with breast cancer and positive axillary nodes: a South-Eastern Cancer Study Group (SEG) Trial.
E. Vélez-García (1992)
Stopping metastases at their source.
S. Hellman (1997)
Adjuvant postoperative radiotherapy, chemotherapy, and immunotherapy in stage III breast cancer
P. Gröhn (1984)
Acute and Subacute Toxicity Associated with Concurrent Adjuvant Radiation Therapy and Paclitaxel in Primary Breast Cancer Therapy
Youseff M Hanna (2002)
Sequencing of chemotherapy and radiation therapy for patients with early stage breast cancer: updated results of a prospective randomized trial
J. Bellon (2001)
Patterns of tumor relapse following mastectomy and adjuvant systemic therapy in patients with axillary lymph node‐positive breast cancer. Impact of clinical, histopathologic, and flow cytometric factors
T. Pisansky (1993)
Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life.
W. Kwan (2002)
Postoperative radiation therapy in mammary carcinoma stage II. Target volume, organs at risk, absorbed dose, time-dose schedule, and dose to organs at risk in a prospective investigation.
A. Arwidi (1979)
To treat or not to treat the internal mammary nodes: a possible compromise.
L. Marks (1994)
Regional nodal failure after conservative surgery and radiotherapy for early-stage breast carcinoma.
A. Recht (1991)
Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation.
B. Fisher (1985)
Tangential breast irradiation with or without internal mammary chain irradiation: results of a randomized trial.
H. Kaija (1995)
Technical factors associated with radiation pneumonitis after local +/- regional radiation therapy for breast cancer.
P. Lind (2002)
Clinical practice guidelines for the care and treatment of breast cancer
TJ Whelan (1998)
A randomized trial of chemotherapy (L-PAM vs CMF) and irradiation for node positive breast cancer
H. Muss (2005)
Late Treatment-Related Morbidity in Breast Cancer Patients Randomized to Postmastectomy Radiotherapy and Systemic Treatment Versus Systemic Treatment Alone
I. Højris (2000)
Clinical practice guidelines for the care and treatment of breast cancer: adjuvant systemic therapy for node-negative breast cancer (summary of the 2001 update).
M. Levine (2001)
Long-term radiation complications following conservative surgery (CS) and radiation therapy (RT) in patients with breast cancer
SM Pierce (1992)
Cancer in the contralateral breast after radiotherapy for breast cancer.
T. Delaney (1992)
The results of radiation therapy for isolated local regional recurrence after mastectomy.
F. Schwaibold (1991)
Adjuvant radiotherapy and chemotherapy in breast cancer
C. Mcardle (1986)
LONG-TERM EFFECTS OF ADJUVANT TAMOXIFEN AND/OR RADIOTHERAPY
S. Rydén (1992)
Risk factors for locoregional recurrence among breast cancer patients: results from International Breast Cancer Study Group Trials I through VII.
A. Wallgren (2003)
Acute myeloid leukemia and myelodysplastic syndrome after doxorubicin-cyclophosphamide adjuvant therapy for operable breast cancer: the National Surgical Adjuvant Breast and Bowel Project Experience.
R. Smith (2003)
Postmastectomy radiotherapy of the chest wall: dosimetric comparison of common techniques.
L. Pierce (2002)
Radiation-induced brachial plexopathy: neurological follow-up in 161 recurrence-free breast cancer patients.
N. K. Olsen (1993)
Rules of evidence and clinical recommendations on the use of antithrombotic agents.
D. Sackett (1986)
Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trialists' Collaborative Group.
A. Howell (1992)
The combination of radiotherapy, adjuvant chemotherapy (cyclophosphamide-doxorubicin-ftorafur) and tamoxifen in stage II breast cancer. Long-term follow-up results of a randomised trial.
C. Blomqvist (1992)
Isolated local-regional recurrence of breast cancer following mastectomy: radiotherapeutic management.
K. Halverson (1990)
The dissection of internal mammary nodes does not improve the survival of breast cancer patients. 30-year results of a randomised trial.
U. Veronesi (1999)
Postmastectomy radiation (RT) outcome in node (N) positive breast cancer patients among N1-3 versus N4+ subset: impact of extracapsular spread (ES)
Locoregional failure 10 years after mastectomy and adjuvant chemotherapy with or without tamoxifen without irradiation: experience of the Eastern Cooperative Oncology Group.
A. Recht (1999)
Postmastectomy radiotherapy. American College of Radiology. ACR Appropriateness Criteria.
M. E. Taylor (2000)
A. Recht (2000)
Phase III study: adjuvant chemotherapy versus radiotherapy plus chemotherapy in women with node-positive breast cancer. A retrospective analysis of 18 years [abstract
H Gervasio (1998)
Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomised trials involving 31 000 recurrences and 24 000 deaths among 75 000 women
Early Breast Cancer Trialist's Collaborative Group (1992)
An Assessment of Delays in Obtaining Definitive Breast Cancer Treatment in Southern Italy
M. Montella (2004)
tional Institutes of Health Consensus Development Statement : adjuvant therapy for breast cancer , November 1 - 3 , 2000
DL Sackett (2001)
National Institutes of Health Consensus Development Statement: adjuvant therapy for breast cancer
P Eifel (2000)
Immunology of Human Tuberculosis: Perspectives for Vaccine Development
J. Ellner (1989)
Concurrent paclitaxel and radiation therapy for breast cancer.
S. Formenti (1999)
Treatment guidelines and techniques in delivery of postmastectomy radiotherapy in management of operable breast cancer.
L. Pierce (2001)
Local recurrence and the deep resection margin in carcinoma of the breast.
S. Mentzer (1986)
Adjuvant chemotherapy and radiation therapy vs. chemotherapy alone for stage II breast cancer patients. A national randomized trial
Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials
M. Clarke (2000)
Tamoxifen for early breast cancer: an overview of the randomised trials
Early Breast Cancer Trialists' Collaborative Group (1998)
Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema.
S. Harris (2001)
EFFECTS OF RADIOTHERAPY AND SURGERY IN EARLY BREAST-CANCER - AN OVERVIEW OF THE RANDOMIZED TRIALS
M. Clarke (1995)
ACR Appropriateness Criteria
C. Maynard (2000)
Does locoregional radiation therapy improve survival in breast cancer? A meta-analysis.
T. Whelan (2000)
Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation.
B. Fisher (2002)
Cardiac effects of adjuvant doxorubicin and radiation therapy in breast cancer patients.
C. Shapiro (1998)
Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. Clinical practice guidelines for the care and treatment of breast cancer
A randomized comparative trial of chemotherapy and irradiation therapy for stage ii breast cancer
M. Cooper (1981)
Randomized trial on the effect of radiotherapy in addition to 6 cycles CMF in node‐positive breast‐cancer patients
C. Schmoor (2000)
Radiation-induced brachial plexus injury: follow-up of two different fractionation schedules.
S. Powell (1990)
The influence of pathologic tumor characteristics on locoregional recurrence rates following mastectomy.
A. Katz (2001)
Reduction of cardiac and lung complication probabilities after breast irradiation using conformal radiotherapy with or without intensity modulation.
C. Hurkmans (2002)
Effects of tamoxifen on pulmonary fibrosis after cobalt-60 radiotherapy in breast cancer patients.
M. Koç (2002)
Acute myeloid leukemia and myelodysplastic syndrome following doxorubicin-cyclophosphamide adjuvant therapy for operable breast cancer: the NSABP experience
RE Smith (2001)
Clinical practice guidelines for the care and treatment of breast cancer : axillary dissection . Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer
J Ragaz (1998)
Implications of extracapsular nodal metastases for treatment and prognosis of breast cancer
W. Donegan (1993)
Respiratory diseases from hard metal or cobalt exposure. Solving the enigma.
M. Demedts (1989)
Radiotherapy-related lung fibrosis enhanced by tamoxifen.
S. Bentzen (1996)
Clinical practice guidelines for the care and treatment of breast cancer: 6. Breast radiotherapy after breast-conserving surgery
T Whelan (2003)
Clinical practice guidelines for the care and treatment of breast cancer : 6 . Breast radiotherapy after breast-conserving surgery ( 2003 update )
T. Whelan (2003)
The sequencing of chemotherapy and radiation therapy after conservative surgery for early-stage breast cancer.
A. Recht (1996)
Significance of axillary lymph node extranodal soft tissue extension and indications for postmastectomy irradiation
J. Mignano (1999)
Increased risk of soft tissue sarcoma after radiotherapy in women with breast carcinoma
J. Huang (2001)
Adjuvant postoperative radiotherapy, chemotherapy, and immunotherapy in stage III breast cancer. II. 5‐year results and influence of levamisole
P. Klefström (1987)
Radical mastectomy versus radical mastectomy plus internal mammary dissection. Five‐year results of an international cooperative study
J. Lacour (1976)
Tumor to fascia margin as a factor in local recurrence after modified radical mastectomy.
T. Ahlborn (1988)
No long-term increase in cardiac-related mortality after breast-conserving surgery and radiation therapy using modern techniques.
A. Nixon (1998)
Clinical practice guidelines for the care and treatment of breast cancer: breast radiotherapy after breast-conserving surgery (summary of the 2003 update).
T. Whelan (2003)
Edema of the arm as a function of the extent of axillary surgery in patients with stage I-II carcinoma of the breast treated with primary radiotherapy.
D. Larson (1986)
[Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials].
G. Noël (2001)
Long-term radiation complications following conservative surgery (CS) and radiation therapy (RT) in patients with early stage breast cancer.
S. M. Pierce (1992)
Consensus Statement on postmastectomy radiation therapy.
J. Harris (1999)
This paper is referenced by
Factors Influencing Axillary Node Metastasis in Breast Cancer
S. Çetintaş (2006)
Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials
EBCTCG (Early Breast Cancer Trialists' Collaborati (2014)
Exercise for women receiving adjuvant therapy of breast-cancer : a systematic review
M. Markes (2011)
Interdisciplinary GoR level III Guidelines for the Diagnosis , Therapy and Follow-up Care of Breast Cancer Short version – AWMF Registry No . : 032-045 OL
R. Kreienberg (2013)
Estrogen receptor, progesterone receptor, HER-2, and response to postmastectomy radiotherapy in high-risk breast cancer: the Danish Breast Cancer Cooperative Group.
M. Kyndi (2008)
A Prospective Evaluation of Health‐Related Quality of Life following Lymphaticovenular Anastomosis for Upper and Lower Extremities Lymphedema
M. Salgarello (2018)
Patient-reported fatigue in breast cancer patients receiving radiation therapy.
B. Wan (2019)
High local recurrence risk is not associated with large survival reduction after postmastectomy radiotherapy in high-risk breast cancer: a subgroup analysis of DBCG 82 b&c.
M. Kyndi (2009)
Primary Breast Cancer Tumor and Patient Characteristics as Predictors of Adjuvant Radiation Therapy
Laura VanderBeek (2017)
Technique and outcome of post-mastectomy adjuvant chest wall radiotherapy-the role of tissue-equivalent bolus in reducing risk of local recurrence.
J. Turner (2016)
Breast cancer radiotherapy and cardiac risk
A. Munshi (2010)
Risk Factors for Locoregional Recurrence After Mastectomy in Stage T1 N0 Breast Cancer
J. Hastings (2014)
Outcome after conservative surgery and breast irradiation in 5,717 patients with breast cancer: implications for supraclavicular nodal irradiation.
L. Livi (2010)
Survival benefit of post-mastectomy radiotherapy in breast carcinoma patients with T1-2 tumor and 1-3 axillary lymph node(s) metastasis.
N. Duraker (2012)
Radiotherapy Delivery for Women with Early Breast Cancer
J. Yarnold (2010)
Does HER 2 status influence locoregional failure rates in breast cancer patients treated with mastectomy for pT 1 – 2 pN 0 disease ?
W. Kwan (2010)
Postmastectomy Radiation Therapy: An Overview for the Practicing Surgeon
R. Jagsi (2013)
Primary versus secondary postmastectomy reconstruction.
D. Chang (2008)
Male breast cancer: Progress, prognosis and future pathways
Kathryn M. Field (2008)
Phase III randomised trial Is the benefit of postmastectomy irradiation limited to patients with four or more positive nodes , as recommended in international consensus reports ? A subgroup analysis of the DBCG 82 b & c randomized trials q
Marie Overgaarda (2007)
Surface and superficial dose dosimetric verification for postmastectomy radiotherapy.
A. Shiau (2012)
The Cambridge post-mastectomy radiotherapy (C-PMRT) index: a practical tool for patient selection.
M. Mukesh (2014)
Diagnostic and therapeutical aspects of lymphedema
R. Damstra (2003)
Lymph Node Ratio May Be Supplementary to TNM Nodal Classification in Node-positive Breast Carcinoma Based on the Results of 2,151 Patients
N. Duraker (2013)
PTHrP, A Biomarker for CNS Metastasis in Triple-Negative Breast Cancer and Selection for Adjuvant Chemotherapy in Node-Negative Disease
Gloria Assaker (2020)
An Update in Breast Cancer Screening and Management
S. Warrier (2016)
Comparison of treatment outcome between breast-conservation surgery with radiation and total mastectomy without radiation in patients with one to three positive axillary lymph nodes.
S. Kim (2011)
PTHrP, a biomarker for CNS metastasis and node-negative adjuvant chemotherapy- selection in triple-negative breast cancer
Gloria Assaker (2019)
Post-mastectomy radiation therapy: translating local benefits into improved survival.
C. S. Chung (2007)
M. Valois (2005)
Caught in the middle: case study of a brachial (sentry) lymph node recurrence after resection and locoregional breast radiotherapy.
G. Lee (2012)
Outcomes of postmastectomy radiotherapy
N. Kalant (2005)See more