Indications for individual internal mammary node irradiation

Is it beneficial for patients with early breast cancer after mastectomy to receive internal mammary node irradiation? A propensity-matched analysis of a retrospective cohort

“…In conclusion, our ndings suggest that, compared with those patients who did not receive IMNI, earlystage breast cancer patients who received IMNI face a reduction in DFS after mastectomy and systemic treatment in western China. However, this effect should be deeply thought-provoking, and randomized studies are urgently needed to further investigate the indications for IMNI, taking into account methods for detecting IMN, the application of innovative radiotherapy technologies, side effects, and survival bene ts [34][35][36] .…”

Internal mammary regional management after neoadjuvant therapy in breast cancer

“…However, the benefits of IMNI may also be diluted to some extent by increasing local control when systemic therapy is effective. So, it is very important to grasp the indication of IMNI accurately 4 . At present, the indication of IMNI without NAT mainly depends on the high-risk factors of IMLN metastases, such as positive axillary nodes.…”

“…At present, the indication of IMNI without NAT mainly depends on the high-risk factors of IMLN metastases, such as positive axillary nodes. According to extended radical mastectomy data, IMLN metastasis occurred in 9.2% of patients with no positive axillary nodes, 19.6% of patients with one to three positive axillary nodes, and 38.3% of patients with more than three positive axillary nodes 4 . The NCCN guideline also recommends IMNI for patients with more than three positive ALNs (category 1) and strongly suggests IMNI for patients with one to three positive ALNs (category 2A) 5 .…”

Optimization of regional nodal irradiation in the era of sentinel lymph node biopsy

“…Survival benefits, adverse effects, and health economics should be considered during clinical application of IMNI. We believe that consideration of indications is key to the successful use of IMNI 21 , 22 . At present, the indications for IMNI depend primarily on the high-risk factors for internal mammary node (IMN) metastases, such as positive axillary nodes.…”

“…At present, the indications for IMNI depend primarily on the high-risk factors for internal mammary node (IMN) metastases, such as positive axillary nodes. According to extended radical mastectomy data, IMN metastasis occurs in 9.2% of patients with no positive axillary nodes, 19.6% of patients with 1–3 positive axillary nodes, and 38.3% of patients with more than 3 positive-axillary nodes 21 . The NCCN Guidelines also recommend IMNI for patients with more than 3 positive ALNs (category 1), and strongly suggest IMNI for patients with 1–3 positive ALNs (category 2A).…”