Evidence map›Paper›PMID 40734573›Full record

ArticleActa oncologica (Stockholm, Sweden)2025

Internal mammary node irradiation in early breast cancer - target coverage and implications on dose to organs at risk.

Lovisa Berg, Jeanette Sporre, Elisabeth Kjellén, Sofie Ceberg, Elinore Wieslander, Sara Alkner

Abstract read
In one paragraph

Article in Acta oncologica (Stockholm, Sweden), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lovisa BergRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden; Department of Oncology, Institute of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden. Lovisa.Berg@skane.se.ORCID 0009-0009-5416-6763
Jeanette SporreClinic of Oncology, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.
Elisabeth KjellénClinic of Oncology, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.
Sofie CebergMedical Radiation Physics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.ORCID 0009-0004-0192-4632
Elinore WieslanderRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.ORCID 0000-0003-1187-7150
Sara AlknerDepartment of Oncology, Institute of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Clinic of Oncology, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.ORCID 0000-0001-8683-9971

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIndications for radiotherapy (RT) of the internal mammary nodes (IMN) in early breast cancer vary between countries. While studies indicate benefits, IMN RT increases the dose to the heart and lungs, and the risk-benefit ratio of this treatment is debated. This study investigates how IMN RT affects dose to organs at risk (OAR) and pneumonitis incidence in a clinical setting.

methodsThis retrospective study includes breast cancer patients receiving adjuvant locoregional RT with and without IMN included in the target volume at Skåne University Hospital, Sweden, from 2018 to 2021. Treatment plans followed national dose-volume criteria, prioritizing lung and heart over IMN coverage. A total of 247 treatment plans for locoregional RT with IMN were compared to 397 without. Dose to OAR, IMN coverage and pneumonitis incidence were investigated.

resultsThe mean ipsilateral lung dose increased by 2.7 Gy with IMN RT (p < 0.001), and the mean heart dose (left-sided treatment) by 0.5 Gy (p < 0.001). Both irradiated and treated volume in relation to planning target volume (PTV) increased with ~20% (p < 0.001). Desired IMN coverage was achieved in 76% of the plans, with lung dose exceeding recommended constraints as the primary reason for decreased target coverage in the remaining plans. Of the 220 patients with follow-up of ≥6 months, 2 (0.9%) were diagnosed with pneumonitis grade 2.

interpretationIntroduction of IMN RT primarily resulted in an increased lung dose. However, rate of symptomatic pneumonitis was low. Most patients achieved desired IMN coverage using 3D-CRT, with lung dose being the limiting factor.

Indexed as

Breast NeoplasmsLymphatic IrradiationLymph NodesOrgans at RiskAdultAgedAged, 80 and overFemaleHeartHumansIncidenceLungMiddle AgedRadiation PneumonitisRadiotherapy, AdjuvantRadiotherapy Dosage

Identifiers

PMID40734573
PMCPMC12320142

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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.