Carolyn Vachani RN, MSN, AOCN
Last Modified: November 18, 2006
The 2006 Worldwide Overview of the Effects of Local Treatments for Early Breast Cancer On Long-term Outcome? "Meta-analysis of the Randomized Trials of Radiotherapy After Mastectomy With Axillary Clearance"
It is well understood that radiation therapy after mastectomy ( PMRT ) improves survival and decreases recurrence rates in women with 4 or more positive lymph nodes. It is also well understood that women with no positive lymph nodes do not benefit from PMRT. This study combined the results of over 400 studies, including 300,000 women, to evaluate the benefit of PMRT for women with 1-3 positive lymph nodes. This is an area which has not been well understood.
PMRT in women with 1-3 positive lymph nodes resulted in fewer recurrences at 5 years (No RT = 24.7% with a recurrence vs. PMRT = 5.3% with a recurrence). After 15 years, women who had radiation therapy were also less likely to die from the disease (No RT = 50.9% had died vs. PMRT = 43.3% had died).
There are potential risks involved in receiving radiation therapy, both short-term and long-term. Women need to balance these risks with the possible benefit they may receive when deciding whether or not to undergo radiation therapy. This study makes the clinical benefit to women with 1-3 positive lymph nodes much clearer.