title: The evolution of regional nodal irradiation in breast cancer.
abstract: Breast cancer regional node management has witnessed many changes over the last decade. Advances in surgical techniques establishing sentinel lymph node biopsy as an alternative to axillary dissection, use of microarray technology for subtyping breast cancer to guide systemic therapy selection, and the expansion of the systemic therapy armamentarium including targeted agents have contributed to changing our strategy from one size fits all to a more tailored approach. There have also been recent landmark studies reported that significantly impact clinical practice in the regional nodal management of breast cancer. As the molecular era of personalized medicine is approaching, we hereby revisit the rational, benefit, and controversies of regional nodal irradiation in the light of the most recent publications.
authors.affiliation: Department of Radiation Oncology, Rutgers Robert Wood Johnson Medical School, New Jersey Medical School and Cancer Institute of New Jersey, New Brunswick, New Jersey.
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Haffty
authors.forename: Omar
authors.initials: O
authors.lastname: Mahmoud
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000235:genetics / Q000266:history* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D008207:Lymphatic Metastasis / Q000532:radiotherapy*; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000628:therapy*; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000266:history* / Q000379:methods; D021701:Sentinel Lymph Node Biopsy / Q000266:history*
keywords: breast cancer; regional nodal irradiation; sentinel lymph node biopsy and biologic subtypes