The curative value of irradiation in the treatment of nondisseminated breast cancer

Data are now available from two randomized trials showing that adjuvant irradiation of the internal mammary and supraclavicular nodes following a radical or modified radical mastectomy results in increased survival rates. A retrospective analysis of 1111 patients treated at M. D. Anderson Hospital with radical mastectomies with and without irradiation to the peripheral lymphatic areas shows equal ten-year survival rates in irradiated and unirradiated patients in spite of the fact that the irradiated patients had a much higher incidence of histologically positive nodes. There is a significant percentage of patients surviving ten-years in 353 patients with locally or regionally advanced tumors treated with simple mastectomy and irradiation without chemotherapy. Radiation of gross local and regional recurrences has a high risk of failure and radiation sequelae.