Mounting evidence for postmastectomy locoregional radiation therapy

Postmastectomy locoregional radiation therapy markedly reduces the risk of locoregional recurrence. Several randomized trials, including two recently updated studies with 10- to 15-year follow-up, demonstrate an improvement i n overall survival with radiation therapy. This improvement is seen in pati ents with one to three positive axillary lymph nodes, as well those with fo ur positive nodes. Therefore, postmastectomy radiation therapy should be co nsidered in all patients with node-positive breast cancer. Computed tomogra phy (CT)-based treatment planning is recommended to minimize the cardiopulm onary morbidity of radiation therapy.