Research progress in internal mammary lymph node irradiation for breast cancer
Cong Binbin,Yu Jinming,Wang Yongsheng
School of Medicine and Life Science,Shandong Academy of Medical Sciences,University of Jinan,Ji’nan 250200,China (Cong BB);Breast Disease Center (Cong BB,Wang YS),Department of Radiation Oncology (Yu JM),Shandong Provincial Cancer Hospital,Shandong University,Ji′nan 250117,China
Abstract:Internal mammary lymph node irradiation (IMLNI) could reduce local recurrence and distant recurrence and improve survival. The NCCN Guidelines have updated the recommends in IMLNI. However, the relative toxicities of IMLNI to the heart and lungs should be carefully considered by clinicians, so individualized indications for IMLNI are needed. Internal mammary sentinel lymph node biopsy (IM-SLNB) could be an accurate technique to guide IMLNI with minimally invasive staging, and provide more survival benefits to patients. This article reviews the benefits of IMLNI, controls of the side effect, and discussion of IMLNI guided by IM-SLNB.
Cong Binbin,Yu Jinming,Wang Yongsheng. Research progress in internal mammary lymph node irradiation for breast cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(9): 1094-1098.
[1] Veronesi U,Cascinelli N,Bufalino R,et al. Risk of internal mammary lymph node metastases and its relevance on prognosis of breast cancer patients[J].Ann Surg,1983,198(6):681-684.DOI:10.1097/00000658-198312000-00002. [2] Veronesi U,Cascinelli N,Greco M,et al. Prognosis of breast cancer patients after mastectomy and dissection of internal mammary nodes[J]. Ann Surg, 1985, 202(6):702-707. DOI:10.1097/00000658-198512000-00007. [3] Cody ⅢHS,Urban JA.Internal mammary node status:a major prognosticator in axillary node-negative breast cancer[J].Ann Surg Oncol, 1995, 2(1):32-37. DOI:10.1007/BF02303699. [4] Cserni G,Szekeres JP.Internal mammary lymph nodes and sentinel node biopsy in breast cancer[J].Surg Oncol, 2001, 10(1-2):25-33.DOI:10.1016/S0960-7404(01)00017-2. [5] Morrow M,Foster RS Jr. Staging of breast cancer:a new rationale for internal mammary node biopsy[J].Arch Surg,1981,116(6):748-751. [6] Johnson N,Soot L,Nelson J,et al. Sentinel node biopsy and internal mammary lymphatic mapping in breast cancer[J].Am J Surg,2000,179(5):386-388.DOI:10.1016/S0002-9610(00)00365-2. [7] Poortmans P.Postmastectomy radiation in breast cancer with one to three involved lymph nodes:ending the debate[J].Lancet,2014,383(9935):2104-2106.DOI:10.1016/S0140-6736(14)60192-6. [8] Early Breast Cancer Trialists′ Collaborative Group (EBCTCG).Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival:an overview of the randomised trials[J].Lancet,2005,366(9503):2087-2106.DOI:10.1016/S0140-6736(05)67887-7. [9] Stemmer SM,Rizel S,Hardan I,et al. The role of irradiation of the internal mammary lymph nodes in high-risk stage Ⅱ to ⅢA breast cancer patients after high-dose chemotherapy:a prospective sequential nonrandomized study[J].J Clin Oncol,2003,21(14):2713-2718.DOI:10.1200/JCO.2003.09.096. [10] EBCTCG (Early Breast Cancer Trialists′ Collaborative Group).Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality:meta-analysis of individual patient data for 8135 women in 22 randomised trials[J]. Lancet, 2014, 383(9935):2127-2135.DOI:10.1016/S0140-6736(14)60488-8. [11] Whelan TJ,Olivotto IA,Parulekar WR,et al. Regional nodal irradiation in early-stage breast cancer[J].N Engl J Med,2015,373(4):307-316.DOI:10.1056/NEJMoa1415340. [12] Poortmans PM,Collette S,Kirkove C,et al. Internal mammary and medial supraclavicular irradiation in breast cancer[J].N Engl J Med,2015,373(4):317-327.DOI:10.1056/NEJMoa1415369. [13] Hennequin C,Bossard N,Servagi-Vernat S,et al. Ten-year survival results of a randomized trial of irradiation of internal mammary nodes after mastectomy[J].Int J Radiat Oncol Biol Phys, 2013, 86(5):860-866. DOI:10.1016/j.ijrobp.2013.03.021. [14] Budach W,Kammers K,Boelke E,et al. Adjuvant radiotherapy of regional lymph nodes in breast cancer-a meta-analysis of randomized trials[J]. Radiat Oncol, 2013, 8:267.DOI:10.1186/1748-717X-8-267. [15] Coates AS,Winer EP,Goldhirsch A,et al. Tailoring therapies-improving the management of early breast cancer:St gallen international expert consensus on the primary therapy of early breast cancer 2015[J].Ann Oncol,2015,26(8):1533-1546.DOI:10.1093/annonc/mdv221. [16] Gradishar WJ,Anderson BO,Balassanian R,et al. NCCN clinical practice guidelines in oncology:breast cancer. Version 1[Z].NCCN,2016. [17] Thorsen LBJ,Offersen BV,Dan H,et al. DBCG-IMN:a population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer[J].J Clin Oncol, 2016, 34(4):314-320. DOI:10.1200/JCO.2015.63.6456. [18] Darby SC,Ewertz M,McGale P,et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer[J].N Engl J Med,2013,368(11):987-998.DOI:10.1056/NEJMoa1209825. [19] Hooning MJ,Botma A,Aleman BMP,et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer[J].J Natl Cancer Inst, 2007,99(5):365-375.DOI:10.1093/jnci/djk064. [20] Nilsson G,Holmberg L,Garmo H,et al. Radiation to supraclavicular and internal mammary lymph nodes in breast cancer increases the risk of stroke[J].Br J Cancer,2009,100(5):811-816.DOI:10.1038/sj.bjc.6604902. [21] Thorsen LBJ,Thomsen MS,Berg M,et al. CT-planned internal mammary node radiotherapy in the DBCG-IMN study:benefit versus potentially harmful effects[J].Acta Oncol,2014,53(8):1027-1034.DOI:10.3109/0284186X.2014.925579. [22] Cao L,Cai G,Chang C,et al. Early cardiac toxicity following adjuvant radiotherapy of left-sided breast cancer with or without concurrent trastuzumab[J].Oncotarget,2016,7(1):1042-1054.DOI:10.18632/oncotarget.6053. [23] Caussa L,Kirova YM,Gault N,et al. The acute skin and heart toxicity of a concurrent association of trastuzumab and locoregional breast radiotherapy including internal mammary chain:a single-institution study[J].Eur J Cancer,2011,47(1):65-73.DOI:10.1016/j.ejca.2010.08.013. [24] Prosnitz RG,Hubbs JL,Evans ES,et al. Prospective assessment of radiotherapy-associated cardiac toxicity in breast cancer patients:analysis of data 3 to 6 years after treatment[J].Cancer,2007,110(8):1840-1850.DOI:10.1002/cncr.22965. [25] Roychoudhuri R,Robinson D,Putcha V,et al. Increased cardiovascular mortality more than fifteen years after radiotherapy for breast cancer:a population-based study[J].BMC Cancer,2007,7:9.DOI:10.1186/1471-2407-7-9. [26] Bird BR,Swain SM.Cardiac toxicity in breast cancer survivors:review of potential cardiac problems[J].Clin Cancer Res,2008,14(1):14-24.DOI:10.1158/1078-0432.CCR-07-1033. [27] Taylor CW,McGale P,Povall JM,et al. Estimating cardiac exposure from breast cancer radiotherapy in clinical practice[J].Int J Radiat Oncol Biol Phys,2009,73(4):1061-1068.DOI:10.1016/j.ijrobp.2008.05.066. [28] Taylor C,Darby SC.Ischemic heart disease and breast cancer radiotherapy:the way forward[J].JAMA Intern Med,2014,174(1):160-161.DOI:10.1001/jamainternmed.2013.9131. [29] MacDonald SM,Jimenez R,Paetzold P,et al. Proton radiotherapy for chest wall and regional lymphatic radiation,dose comparisons and treatment delivery[J].Radiat Oncol,2013,8:71.DOI:10.1186/1748-717X-8-71. [30] Coon AB,Dickler A,Kirk MC,et al. Tomotherapy and multifield intensity-modulated radiotherapy planning reduce cardiac doses in left-sided breast cancer patients with unfavorable cardiac anatomy[J].Int J Radiat Oncol Biol Phys,2010,78(1):104-110.DOI:10.1016/j.ijrobp.2009.07.1705. [31] Formenti SC,Gidea-Addeo D,Goldberg JD,et al. Phase Ⅰ—Ⅱ trial of prone accelerated intensity modulated radiation therapy to the breast to optimally spare normal tissue[J].J Clin Oncol,2007,25(16):2236-2242.DOI:10.1200/JCO.2006.09.1041. [32] Ma JL,Li JY,Xie J,et al. Post mastectomy linac IMRT irradiation of chest wall and regional nodes:dosimetry data and acute toxicities[J].Radiat Oncol,2013,8:81.DOI:10.1186/1748-717X-8-81. [33] Fung E,Hendry J.External beam radiotherapy (EBRT) techniques used in breast cancer treatment to reduce cardiac exposure[J].Radiography,2013,19(1):73-78.DOI:10.1016/j.radi.2012.09.007. [34] Yu JM,Li G,Li JB,et al. The pattern of lymphatic metastasis of breast cancer and its influence on the delineation of radiation fields[J].Int J Radiat Oncol Biol Phys,2005,61(3):874-878.DOI:10.1016/j.ijrobp.2004.06.252. [35] Huang O,Wang LP,Shen KW,et al. Breast cancer subpopulation with high risk of internal mammary lymph nodes metastasis:analysis of 2,269 Chinese breast cancer patients treated with extended radical mastectomy[J].Breast Cancer Res Treat,2008,107(3):379-387.DOI:10.1007/s10549-007-9561-4. [36] Veronesi U,Valagussa P.Inefficacy of internal mammary nodes dissection in breast cancer surgery[J].Cancer,1981,47(1):170-175.DOI:10.1002/1097-0142(19810101)47:1<170::AID-CNCR2820470128>3.0.CO;2-C. [37] Noguchi M,Ohta N,Thomas M,et al. Risk of internal mammary lymph node metastases and its prognostic value in breast cancer patients[J].J Surg Oncol,1993,52(1):26-30.DOI:10.1002/jso.2930520108. [38] Veronesi U,Arnone P,Veronesi P,et al. The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series[J].Ann Oncol,2008,19(9):1553-1560.DOI:10.1093/annonc/mdn183. [39] Cong BB,Qiu PF,Wang YS.Internal mammary sentinel lymph node biopsy:minimally invasive staging and tailored internal mammary radiotherapy[J].Ann Surg Oncol,2014,21(7):2119-2121.DOI:10.1245/s10434-014-3650-5. [40] Connolly JL.Changes and problematic areas in interpretation of the AJCC cancer staging manual,6th edition,for breast cancer[J].Arch Pathol Lab Med,2006,130(3):287-291. [41] Qiu PF,Cong BB,Zhao RR,et al. Internal mammary sentinel lymph node biopsy with modified injection technique:high visualization rate and accurate staging[J].Medicine (Baltimore),2015,94(41):e1790.DOI:10.1097/MD.0000000000001790. [42] Cong BB,Qiu PF,Liu YB,et al. Validation study for the hypothesis of internal mammary sentinel lymph node lymphatic drainage in breast cancer[J].Oncotarget,2016,7(27):41996-42006.DOI:10.18632/oncotarget.9634.