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Home:
Meeting
Highlights: 2000
Interactive Report
Postmastectomy
Radiation Therapy
19.
43-year-old woman, ER/PR+, has modified radical mastectomy for a
2.5 centimeter infiltrating ductal carcinoma. Would you recommend
chest wall radiation?
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2
Positive Nodes
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5
Positive Nodes
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| Yes |
12%
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56%
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| No |
88%
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44%
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Patrick
Borgen, MD
We
would radiate the patient with five nodes, but not the patient with
two nodes. I'm very surprised that 44% of the attendees would not
radiate the patient with five nodes. Gordon Schwartz had a consensus
conference six or eight months before the 2000 Miami meeting, where
clearly, everybody at the meeting —and it was really a lot
of people —decided on four or more nodes. So, we certainly
are radiating at four. The real dilemma is at two or three. In general,
we're not radiating those people. Patients with wide margins, T2
cancers, two positive nodes, are receiving aggressive chemotherapy.
But that's more on a case-by-case basis. We're talking about the
data from the two reported trials showing an advantage in that subset,
but I would say the majority of people with two positive nodes are
not being radiated.
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