Article révisé par les pairs
| Résumé : | Recent reports suggest that medial breast tumors are independently associated with decreased disease-free and overall survival compared with lateral breast tumors. Surgical evidence indicates that medial tumors with positive axillary nodes have an increased rate of internal mammary node (IMN) metastases. It is hypothesized that IMN disease that does not receive local therapy (surgery or radiotherapy) may be a reservoir for eventual systemic spread, and may account for the increased recurrence and death rates associated with medial tumors. Although early trials are divided as to the benefit of local IMN therapy, they were conducted largely in the absence of adjuvant systemic therapy. Are there reliable methods to assess IMN status, and does IMN irradiation significantly reduce the excess risk of medial tumors in women who receive today's "standard" adjuvant systemic therapy? |
