Postmastectomy radiation therapy: A surgical perspective.

Overview

Controversy exists about whether postmastectomy radiotherapy prolongs survival or is merely of benefit to maintain local control. Surgical series of patients treated by radical or modified radical mastectomy alone show locoregional failure rates ranging from 4% to 26%. The likelihood of involvement of supraclavicular and internal mammary nodal metastases increases as the extent of axillary nodal involvement increases. Adjuvant systemic therapy appears to have limited impact on the incidence of locoregional failure. Untreated nodal disease is a potential source of tumor dissemination and provides a biological rationale for a survival benefit for irradiation.