SynthesisRadiation oncology (London, England)2013
Adjuvant radiotherapy of regional lymph nodes in breast cancer - a meta-analysis of randomized trials.
Synthesis in Radiation oncology (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03101683 (Partial Chest Wall Radiation Therapy After Total/Skin Sparing Mastectomy and Immediate Implant-based Reconstruction for Breast Cancer Patients at Increased Risk of Local Recurrence), which is not on this map. Cited by 50 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Partial Chest Wall Radiation Therapy After Total/Skin Sparing Mastectomy and Immediate Implant-based Reconstruction for Breast Cancer Patients at Increased Risk of Local Recurrence
Who cites it
50 citing papers in PubMed, 7 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- DEGRO practical guidelines: radiotherapy of breast cancer-regional nodal irradiation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Guideline
- Post-neoadjuvant treatment with capecitabine and trastuzumab emtansine in breast cancer patients-sequentially, or better simultaneously?Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Pooled it
- Pooled it
- Adjuvant radiation therapy of regional lymph nodes in breast cancer - a meta-analysis of randomized trials- an update.Radiation oncology (London, England) · 2015Pooled it
- DEGRO practical guidelines for radiotherapy of breast cancer V: Therapy for locally advanced and inflammatory breast cancer, as well as local therapy in cases with synchronous distant metastases.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2015Guideline
- DEGRO practical guidelines for radiotherapy of breast cancer IV: radiotherapy following mastectomy for invasive breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2014Guideline
- DEGRO practical guidelines: radiotherapy of breast cancer III--radiotherapy of the lymphatic pathways.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2014Guideline
- Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment.World journal of surgical oncology · 2024Article
- A nomogram with Nottingham prognostic index for predicting locoregional recurrence in breast cancer patients.Frontiers in oncology · 2024Article
- The challenging patient in autologous breast reconstruction: obesity, breast ptosis and beyond.Gland surgery · 2023Review
- The optimal regional irradiation volume for breast cancer patients: A comprehensive systematic review and network meta-analysis of published studies.Frontiers in oncology · 2023Article
- Radiotherapy of Breast Cancer in Laterally Tilted Prone vs. Supine Position: What about the Internal Mammary Chain?Journal of personalized medicine · 2022Article
- The Lymphatic System in Breast Cancer: Anatomical and Molecular Approaches.Medicina (Kaunas, Lithuania) · 2021Review
- Breast-conserving surgery with or without irradiation in women with invasive ductal carcinoma of the breast receiving preoperative systemic therapy: A cohort study.Breast (Edinburgh, Scotland) · 2020Article
- OPTimizing Irradiation through Molecular Assessment of Lymph node (OPTIMAL): a randomized open label trial.Radiation oncology (London, England) · 2020Article
- Long-term quality of life after preoperative radiochemotherapy in patients with localized and locally advanced breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Article
- The study of internal mammary lymph node dissection guided by modified radiotracer injection technique in breast cancer-a case report and review.Gland surgery · 2020Article
- Internal Mammary Sentinel Lymph Node Biopsy in Clinically Axillary Lymph Node-Positive Breast Cancer: Diagnosis and Implications for Patient Management.Annals of surgical oncology · 2020Article
- Does Direct and Indirect Exposure to Ionising Radiation Influence the Metastatic Potential of Breast Cancer Cells.Cancers · 2020Review
- Impact of patient and treatment characteristics on heart and lung dose in adjuvant radiotherapy for left-sided breast cancer.Radiation oncology (London, England) · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRadiotherapy (RT) improves overall survival (OS) of breast cancer patients after breast conserving surgery and after mastectomy in patients with involved lymph nodes (LN). The contribution of RT to the regional LN to this survival benefit was poorly understood. Recently, the results of three large randomized trials addressing this question have become available. MATERIAL AND
methodsThe published abstracts (full publication pending) of the MA.20 (n=1832) and the EORTC 22922-10925 (EORTC) (n=4004) trial and the full publication of the French trial (n=1334) were basis of the meta-analysis. Main eligibility criteria were positive axillary LN (all trials), LN negative disease with high risk for recurrence (MA.20), and medial/central tumor location (French, EORTC). The MA.20 and the EORTC trial tested the effect of additional regional RT to the internal mammary (IM) LN and medial supraclavicular (MS) LN, whereas in the French trial all patients received RT to the MS-LN and solely RT to the IM-LN was randomized. Primary endpoint was OS. Secondary endpoints were disease-free survival (DFS) and distant metastasis free survival (DMFS).
resultsRegional RT of the MS-LN and the IM-LN (MA.20 and EORTC) resulted in a significant improvement of OS (Hazard Ratio (HR) 0.85 (95% CL 0.75 - 0.96)). Adding the results of the French trial and using the random effects model to respect the different design of the French trial, the effect on OS of regional radiotherapy was still significant (HR 0.88 (95% CL 0.80 - 0.97)). The absolute benefits in OS were 1.6% in the MA.20 trial at 5 years, 1.6% in the EORTC trial at 10 years, and 3.3% in the French trial at 10 years (not significant in single trials). Regional radiotherapy of the MS-LN and the IM-LN (MA.20 and EORTC) was associated with a significant improvement of DFS (HR 0.85 (95% CL 0.77 - 0.94)) and DMFS (HR 0.82 (95% CL 0.73 - 0.92)). The effect sizes were not significantly different between trials for any end point.
conclusionAdditional regional radiotherapy to the internal mammary and medial supraclavicular lymph nodes statistically significantly improves DFS, DMFS, and overall survival in stage I-III breast cancer.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.