Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute and Honorary Professor of Medicine at Cardiff University School of Medicine, shared a post on LinkedIn:
“New Evidence on RNI After Neoadjuvant Chemotherapy and Breast-Conserving Therapy
A large NCDB analysis published on 19 Feb 2026 shows that regional nodal irradiation (RNI) does not improve overall survival (OS) in clinically node-positive (cN+) breast cancer patients who achieve a complete response after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT).
Importantly, in the subgroup of patients who remain pathologically node-positive (ypN+) after NAC, RNI was associated with worse overall survival compared with no RNI.
These findings support:
- Individualizing the decision to omit RNI in patients downstaged to ypN0 after NAC + BCT
- Urgent need for further research into the potential benefits vs harms of RNI in ypN+ patients.”
Title: The role of regional nodal irradiation in clinically node-positive breast cancer patients who undergo neoadjuvant chemotherapy and breast-conserving surgery
Authors: Mahtab Vasigh, Austin Williams, Jill Hasler, Allison Aggon, Randy Cohen, Rebecca Shulman, Shelly Hayes, Penny Anderson, Andrea Porpiglia, Mary Pronovost, Matthew Pierotti, Christian Cruz Pico, Richard Bleicher
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