Controversies regarding the use of radiation after mastectomy in breast cancer
Controversies regarding the use of radiation after mastectomy in breast cancer
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DOI：
10.1634/theoncologist.7-6-539
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发表时间：
2002-01-01
期刊：
影响因子：
5.8
通讯作者：
McNeese, MD
中科院分区：
文献类型：
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作者：
Buchholz, TA;Strom, EA;McNeese, MD
尽管多年的临床研究，仍然有许多悬而未决的问题，乳房切除术后放射。很明显，放射治疗在局部晚期或炎性乳腺癌患者的多学科管理中起着至关重要的作用。它也被认为是乳房切除术后放射是不需要大多数妇女与非侵入性疾病或I期疾病。研究II期或III期乳腺癌女性放射治疗的随机临床试验表明，乳房切除术后增加放射治疗可以降低局部复发率，从而提高生存率。然而，其他数据表明，乳房切除术和化疗后局部区域复发的风险是低的小肿瘤和1至3个阳性淋巴结的患者，导致一些人质疑是否乳房切除术后放疗是有用的这组。第二个争议是关于乳房切除术后放疗和乳房再造的顺序。在本文中，我们讨论了这些争议，回顾了相关数据，并提供了解决这些问题的机构方法。
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.