After surgery to remove breast cancer, many women have radiation to the breast area. Also, many doctors recommend that women also have radiation to the lymph nodes. Two new studies analyzed whether radiation to the lymph nodes was beneficial. These studies suggest that radiation ot the lymph nodes reduces the risk of cancer recurrence, but does not improve overall survival from breast cancer.
The first study included 1,832 women diagnosed with early-stage breast cancer with a high risk of recurrence and also had lumpectomy. Half were treated with whole-breast radiation plus regional node radiation (the nodal radiation group) and the other half were treated with whole breast radiation alone (the control group). After about 10 years of follow-up, the researchers found that about 82% of the women in each group were alive, so there was no overall difference in survival. However, there was a difference in disease-free survival rates – how long the women lived without the cancer recurring. 82% in the first group and 77% in the second group were alive with no recurrence. Also, the women in the nodal radiation group were more likely to have a side effects.
The second study included 4,004 women from 13 countries. All the women were diagnosed with early-stage breast cancer and had lumpectomy or mastectomy. The women were also split in half and randomly assigned to a nodal radiation group and a control group. After about 10 years of follow up, about 81% of the women in each group were alive. So, like the first study, there was no difference in overall survival. The difference in distant disease-free survival – how long the women lived without the cancer recurring in a part of the body away from the breast — was 72.1 % in the first group and 69.1% in the second. This shows that radiation to the lymph nodes made a difference. 78% in first group and 75% in the second group were alive with no distant recurrence. This study did not apply to women diagnosed with cancers located nearer to the arm pit.
In conclusion, radiation to the lymph nodes may be a good choice, especially if your risk of recurrence is higher than average.