Gustavo Viani: Internal Mammary Node Radiation, A Survival Boost for Breast Cancer Patients?
Gustavo Viani, Professor of Radiation Oncology at Ribeirão Preto Medical School, posted on X:
“Internal Mammary Node Radiation: A Survival Boost for Breast Cancer Patients?
Study Design:
•Nationwide cohort (DBCG IMN2), 4,541 with node-positive breast cancer (2007–2014)
•IMNI Allocation: Right-sided tumors received IMNI; left-sided did not (to avoid toxicity)
•Systemic therapies included taxane-based chemotherapy, aromatase inhibitors, and trastuzumab
•Radiation: 3D-based techniques delivering 48–50 Gy in 24–25 fractions
Key Findings:
•15-year OS: 65.0% with IMNI vs. 60.8% without (HR: 0.85; p=0.0016).
• decreased breast cancer mortality (HR: 0.84; p=0.0077).
• decreased rates of distant metastasis (HR: 0.87; p=0.026).
•No safe subgroup identified for IMNI omission, even in low-burden disease (1–3 nodes)
Takeaway: IMNI remains essential in node-positive breast cancer, improving outcomes even with modern systemic and radiation techniques.”
Gustavo Viani, MD is an Associate Professor in the Department of Medical Imaging, Hematology, and Oncology at Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP). Dr. Viani’s research focuses on radiation oncology, with expertise in brachytherapy, stereotactic radiosurgery, dose fractionation, radiation tolerance, and overall oncology practices.
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