International Variation in Criteria for Internal Mammary Chain Radiotherapy.
AuthorsDuane, F K
Darby, S C
Vallis, K A
Taylor, C W
AffiliationSt Luke's Radiation Oncology Network, St. James's Hospital, Dublin, Ireland
KeywordsInternal mammary chain
MetadataShow full item record
AbstractAims; Evidence has emerged that internal mammary chain (IMC) radiotherapy reduces breast cancer mortality, leading to changes in treatment guidelines. This study investigated current IMC radiotherapy criteria and the percentages of patients irradiated for breast cancer in England who fulfilled them. Materials and methods; A systematic search was undertaken for national guidelines published in English during 2013–2018 presenting criteria for ‘consideration of’ or ‘recommendation for’ IMC radiotherapy. Patient and tumour variables were collected for patients who received breast cancer radiotherapy in England during 2012–2016. The percentages of patients fulfilling criteria stipulated in each set of guidelines were calculated. Results: In total, 111 729 women were recorded as receiving adjuvant breast cancer radiotherapy in England during 2012–2016 and full data were available on 48 095 of them. Percentages of patients fulfilling IMC radiotherapy criteria in various national guidelines were: UK Royal College of Radiologists 13% (6035/48 095), UK National Institute for Health and Care Excellence 18% (8816/48 095), Germany 32% (15 646/48 095), Ireland 56% (26 846/48 095) and USA 59% (28 373/48 095). Differences between countries occurred because in Ireland and the USA, treatment may be considered in some node-negative patients, whereas in the UK, treatment is considered if at least four axillary nodes are involved or for high-risk patients with one to three positive nodes. In Germany, treatment may be considered for all node-positive patients. Conclusions: There is substantial variability between countries in criteria for consideration of IMC radiotherapy, despite guidelines being based on the same evidence. This will probably lead to large variations in practice and resource needs worldwide.
- [Comparation study of incidental irradiation dose to the internal mammary chain during postmastectomy radiotherapy for patients treated with different irradiation techniques].
- Authors: Wang W, Meng YT, Song YF, Sun T, Xu M, Shao Q, Zhang YJ, Li JB
- Issue date: 2018 May 23
- Unplanned irradiation of internal mammary lymph nodes in breast cancer.
- Authors: Kanyilmaz G, Aktan M, Koc M, Demir H, Demir LS
- Issue date: 2017 Jun
- Sentinel node biopsy in the evaluation of the internal mammary node chain in patients with breast cancer.
- Authors: Carcoforo P, Basaglia E, Soliani G, Bergossi L, Corcione S, Pozza E, Feggi L
- Issue date: 2002 May-Jun
- Screening mammography for women aged 40 to 49 years at average risk for breast cancer: an evidence-based analysis.
- Authors: Medical Advisory Secretariat.
- Issue date: 2007
- Axillary Surgery Following Neoadjuvant Chemotherapy - Multidisciplinary Guidance From the Association of Breast Surgery, Faculty of Clinical Oncology of the Royal College of Radiologists, UK Breast Cancer Group, National Coordinating Committee for Breast Pathology and British Society of Breast Radiology.
- Authors: Gandhi A, Coles C, Makris A, Provenzano E, Goyal A, Maxwell AJ, Doughty J
- Issue date: 2019 Sep