Are you confused about how to factor in response to neoadjuvant chemo in decision making regarding regional nodal irradiation (RNI) for breast cancer? You’re not alone. Here’s a comprehensive review of the current data on the subject published over the past couple of years. Yes, we’ll be awaiting results of B-51 for a while. In the meantime, almost all retrospective studies have indicated that RNI contributes to locoregional control at most—and not to disease-free or overall survival)—for patients who are ypN0.On the other hand, you can expect an overall survival benefit for virtually all patients who are ypN+. This led an expert panel to reach a strong consensus against blanket recommendations for RNI for all cN+ patients. Conversely, they suggest women with cN1 converted to ypN0 should rarely receive RNI unless there are other major risk factors.
- Meattini, Curr Opin Oncol 2022