Evidence map›Paper›PMID 40956531›Full record

ArticleAnnals of surgical oncology2025

Postmastectomy Radiation Therapy: An ASTRO/ASCO/SSO Clinical Practice Guideline.

Rachel B Jimenez, Yara Abdou, Penny Anderson, Parul Barry, Lisa Bradfield, Julie A Bradley, Lourdes D Heras, Atif Khan, Cindy Matsen, Rachel Rabinovitch and 10 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. DEGRO practical guidelines: radiotherapy of breast cancer-regional nodal irradiation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Guideline
  2. Article
  3. Article
4 · The record

Corrections and comments

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

20 authors.

Rachel B JimenezDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA. rbjimenez@mgb.org.
Yara AbdouDepartment of Medical Oncology, University of North Carolina, Chapel Hill, NC, USA.
Penny AndersonDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
Parul BarryDepartment of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA.
Lisa BradfieldAmerican Society for Radiation Oncology, Arlington, VA, USA.
Julie A BradleyDepartment of Radiation Oncology, University of Florida, Jacksonville, FL, USA.
Lourdes D HerasPatient Representative, Surviving Breast Cancer, Gilbert, AZ, USA.
Atif KhanDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Cindy MatsenDepartment of Surgery, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA.
Rachel RabinovitchDepartment of Radiation Oncology, University of Colorado Denver, Aurora, CO, USA.
Chantal ReynaDepartment of Surgery, Loyola University Medical Center, Chicago, IL, USA.
Kilian E SalernoRadiation Oncology Branch, National Cancer Institute, Bethesda, MD, USA.
Sarah E SchellhornDepartment of Medicine, Yale School of Medicine, New Haven, CT, USA.
Deborah SchofieldDepartment of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Kekoa TaparraDepartment of Radiation Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Iman WashingtonDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Jean L WrightDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA.
Youssef H ZeidanDepartment of Radiation Oncology, Florida International University and Lynn Cancer Institute, Boca Raton, FL, USA.
Richard C ZellarsDepartment of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, USA.
Kathleen C HorstDepartment of Radiation Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis guideline provides evidence-based recommendations on the use of postmastectomy radiation therapy (PMRT) in the treatment of breast cancer. PMRT refers to the treatment of the chest wall and ipsilateral regional nodes, including at-risk axillary, supra/infraclavicular, and internal mammary nodes. Updated recommendations detail indications for PMRT in the upfront surgical setting and after neoadjuvant systemic therapy, and provide guidance on appropriate target volumes, dosing, and treatment techniques.

methodsThe American Society for Radiation Oncology, American Society of Clinical Oncology, and the Society of Surgical Oncology convened a multidisciplinary task force to address 4 key questions focused on radiation therapy (RT) in patients with breast cancer who undergo mastectomy including (1) indications for PMRT after upfront surgery, (2) indications for PMRT after neoadjuvant systemic therapy followed by surgery, (3) appropriate PMRT treatment volumes and dose-fractionation regimens, and (4) treatment techniques. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for quality of evidence grading and strength of recommendation.

resultsAfter upfront mastectomy, PMRT is indicated for most patients with node-positive breast cancer and select patients with node-negative disease. PMRT is also recommended after neoadjuvant systemic therapy, both for patients presenting with locally advanced disease and for those with residual nodal disease at the time of surgery. PMRT is conditionally recommended for patients with cT1-3N1 or cT3N0 breast cancer with pathologically negative nodes after neoadjuvant systemic therapy (ypNO). When PMRT is delivered, treatment to the ipsilateral chest wall/reconstructed breast and regional lymphatics is recommended, with moderate hypofractionation preferred, but with conventional fractionation approaches acceptable in rare cases. Computed tomography-based volumetric treatment planning with 3-dimensional conformal RT is recommended, with intensity modulated RT advised when 3-dimensional conformal RT is unable to achieve treatment goals. Deep inspiration breath hold techniques are also recommended for normal tissue sparing. For patients with skin involvement, positive superficial margins, and/or lymphovascular invasion, the use of a bolus is recommended, but the routine use of tissue-equivalent bolus is not recommended.

conclusionsThese evidence-based recommendations guide clinical practice on the use of PMRT in patients with breast cancer. © 2025 American Society for Radiation Oncology, American Society of Clinical Oncology and Society of Surgical Oncology. Published by Elsevier Inc on behalf of American Society for Radiation Oncology, by Wolters Kluwer Health on behalf of American Society of Clinical Oncology and by Springer Nature on behalf of Society of Surgical Oncology. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Identifiers

PMID40956531

What OpenQuestion holds

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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.