Post-mastectomy radiotherapy

Between 1997 and 1999, three studies re-ignited the debate on post-mastectomy radiation therapy (PMRT). Despite 20 years of follow-up and multiple re-analyses, the results of these studies still generate vigorous debate among the learned men and women who care for breast cancer patients. In honor of the 10th anniversary of the Danish Breast Cancer Cooperative Group Post-Mastectomy trial 82c publication, the following review offers the reader a brief history of the controversies that preceded and followed these publications. Other related controversies, PMRT in the setting of neo-adjuvant chemotherapy, positive margins or T3N0 primary tumors, as well as internal mammary lymph node irradiation, are also presented. Finally, we present a brief discussion about the toxicities associated with PMRT. This review will familiarize the reader with often discussed/debated issues concerning PMRT and prepare them to enter the debate.