SynthesisRadiation oncology (London, England)2015
Adjuvant radiation therapy of regional lymph nodes in breast cancer - a meta-analysis of randomized trials- an update.
Synthesis in Radiation oncology (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- DEGRO practical guidelines: radiotherapy of breast cancer-regional nodal irradiation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Guideline
- Radiotherapy of Breast Cancer-Professional Guideline 1st Central-Eastern European Professional Consensus Statement on Breast Cancer.Pathology oncology research : POR · 2022Pooled it
- Can internal mammary lymph nodes irradiation bring survival benefits for breast cancer patients? A systematic review and meta-analysis of 12,705 patients in 12 studies.Radiation oncology (London, England) · 2021Pooled it
- Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer : A systematic review.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2018Pooled it
- Exposure of the lungs in breast cancer radiotherapy: A systematic review of lung doses published 2010-2015.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2018Pooled it
- Reproducibility of repeated breathhold and impact of breathhold failure in whole breast and regional nodal irradiation in prone crawl position.Scientific reports · 2022Trial
- Is there an impact of autoimmune rheumatological diseases on cutaneous toxicity in breast cancer adjuvant radiotherapy? A mono-institutional experience.Breast cancer (Tokyo, Japan) · 2026Article
- Risk factors for early-onset radiodermatitis in patients with locally advanced breast cancer: a comparative analysis of volumetric modulated arc therapy and intensity-modulated radiotherapy.Breast cancer (Tokyo, Japan) · 2025Article
- [5th Hungarian Breast Cancer Consensus Conference - radiotherapy guidelines].Magyar onkologia · 2025Article
- A Review on the Impact of Aberrant Methylation in Breast Cancer: Diagnostic, Prognostic, and Therapeutic Approaches.Iranian journal of biotechnology · 2024Review
- Escalation and De-Escalation of Adjuvant Radiotherapy in Early Breast Cancer: Strategies for Risk-Adapted Optimization.Cancers · 2024Review
- Article
- A Questionnaire Survey of Current Practice in the Management of Internal Mammary Lymph Nodes in Breast Cancer.South Asian journal of cancer · 2024Article
- Article
- Optimization of regional nodal irradiation in the era of sentinel lymph node biopsy.Cancer biology & medicine · 2023Article
- A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold?Technical innovations & patient support in radiation oncology · 2023Article
- Simultaneous integrated boost within the lymphatic drainage system in breast cancer: A single center study on toxicity and oncologic outcome.Frontiers in oncology · 2023Article
- Comparison of nodal staging between CT, MRI, and [European journal of nuclear medicine and molecular imaging · 2022Article
- A hierarchical approach to combine histological grade and immunohistochemical factors to identify high-risk luminal breast cancers.Ecancermedicalscience · 2022Article
- Prognosis value of lymphovascular invasion in patients with invasive ductal breast carcinoma according to lymph node metastasis status.Ecancermedicalscience · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdjuvant radiotherapy (RT) of regional lymph nodes (LN) in early breast cancer is still a matter of debate. RT increases the Overall survival (OS) rate of breast cancer patients after breast conserving surgery and after mastectomy in patients with involved LN. The contribution of RT to regional LN to this improvement was poorly identified. Recently, the results of three large randomized trials addressing this question were published as full papers. MATERIAL AND
methodsPublished data of the MA.20 (n = 1832), the EORTC22922-10925 (EORTC) (n = 4004) trial and the French trial (n = 1334) were the foundation of this meta-analysis. Major eligibility criteria were positive i) axillary LN (all trials), ii) LN negative disease with high risk for recurrence (MA.20), and iii) medial/central tumor location (French, EORTC). The MA.20 and the EORTC trial analyzed 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 MS-LN and IM-LN (MA.20 and EORTC) resulted in a significant improvement of OS [Hazard Ratio (HR) 0.88 (95 % CL 0.78 - 0.99)]. Adding results of the French trial and using a random effects model to respect the different design of the French trial, the effect on OS of regional RT remained significant [HR 0.90 (95 % CL 0.82 - 0.99)]. The absolute benefits in OS were 1 % in the MA.20 trial at 10 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 RT of MS-LN and IM-LN (MA.20 and EORTC) yielded to a significant improvement of DFS [HR 0.86 (95 % CL 0.78 - 0.95)] and DMFS [HR 0.84 (95 % CL 0.75 - 0.94)].
conclusionAdditional regional RT to the internal mammary and medial supraclavicular LN statistically significantly improved DFS, DMFS, and OS in stage I-III breast cancer.
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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.