This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Buchholz, T. A. Articles by McNeese, M. D. Search for Related Content PubMed PubMed Citation Articles by Buchholz, T. A. Articles by McNeese, M. D.

Controversies Regarding the Use of Radiation After Mastectomy in Breast Cancer

Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA

Correspondence: Thomas A. Buchholz, M.D., Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. Telephone: 713-745-0487; Fax: 713-792-3642; e-mail: tbuchhol{at}mdanderson.org

Despite years of clinical study, there are still many unanswered questions regarding postmastectomy radiation. It is clear that radiation therapy plays a critical role in the multidisciplinary management of patients with locally advanced or inflammatory breast cancer. It is also accepted that postmastectomy radiation is not required for most women with noninvasive disease or stage I disease. Randomized clinical trials studying radiation treatments for women with stage II or III breast cancer have shown that the addition of radiation after mastectomy can reduce local-regional recurrence rates, which then improves survival. However, other data have indicated that the risk of local-regional recurrence after mastectomy and chemotherapy is low for patients with small tumors and one to three positive lymph nodes, leading some to question whether postmastectomy radiation is useful for this group. A second controversy regards the sequencing of postmastectomy radiation and breast reconstruction. In this article we discuss these controversies, review the data that are relevant, and provide our institutional approaches to these issues.

Key Words. Radiation • Mastectomy • Chemotherapy • Local-regional recurrence • Breast reconstruction

This article has been cited by other articles:

				B. D. Smith, G. L. Smith, and B. G. Haffty Postmastectomy Radiation and Mortality in Women With T1-2 Node-Positive Breast Cancer J. Clin. Oncol., March 1, 2005; 23(7): 1409 - 1419. [Abstract] [Full Text] [PDF]