Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute, shared on LinkedIn:
“New study: MRI response may help personalize internal mammary node radiotherapy after neoadjuvant therapy
A new study by Yushuo Peng and colleagues, published online in International Journal of Radiation Oncology, Biology, Physics, explores whether MRI-assessed internal mammary node clinical complete response (icCR) after neoadjuvant therapy can help guide postoperative IMN radiotherapy boost decisions.
In 208 patients with clinically positive IMNs at baseline, the overall cohort did not show a significant DFS benefit from an IMN boost. However, an important interaction emerged based on post-NAT MRI response:
- No icCR: IMN boost was associated with improved DFS (HR 0.36, 95% CI 0.14–0.93; P=0.034).
- icCR achieved: No significant DFS improvement was observed with an IMN boost (HR 1.13, 95% CI 0.47–2.74; P=0.781).
These findings raise an important question for contemporary breast cancer radiotherapy:
Can treatment response on MRI help us move from a one-size-fits-all approach toward response-adapted regional nodal irradiation?
The results are retrospective and require prospective validation, but they highlight the potential value of integrating imaging response into postoperative radiotherapy decision-making-particularly when balancing oncologic benefit against treatment-related toxicity.”
Title: MRI-Based Internal Mammary Node Response After Neoadjuvant Therapy to Guide Postoperative Internal Mammary Node Radiotherapy Boost in Breast Cancer
Authors: Yushuo Peng, Siyuan Zhang, Jian Tie, Yirong Xiang, Chen Shi, Changkuo Guo, Zhaoqing Fan, Weihu Wang
Read The Full Article
You can also read: Neoadjuvant SBRT and Immunotherapy Show Potential in High-Risk ER+/HER2− Breast Cancer
