Andres Rodriguez Mignola, Radiation Oncologist at Ángel Roffo Institute of Oncology, shared a post on LinkedIn:
“Radiotherapy in Breast Cancer Summary 2025
NSABP B-51 / RTOG 1304
- Design: Phase III Randomized Controlled Trial.
- Patients: N = 1,641.
- Results: Focused on patients converting from node-positive (cN1) to node-negative (ypN0) after neoadjuvant chemotherapy. The study found no significant difference in the 5-year Invasive Breast Cancer-Free Interval (91.8% without Regional Nodal Irradiation vs. 92.7% with it). It confirms that nodal irradiation can be safely omitted in patients achieving a pathological complete response in the axilla.
DBCG IMN2
- Design: Large Prospective Population-Based Cohort.
- Patients: N = 4,541.
- Results: This study analyzed the impact of Internal Mammary Node (IMN) irradiation. It demonstrated a clinically significant overall survival benefit, with an 8-percentage point improvement at 8 years for node-positive patients who received IMN irradiation compared to those who did not, confirming its value even in the context of modern systemic therapy.
SUPREMO Trial (BIG 2-04)
- Design: Phase III Randomized Controlled Trial.
- Patients: N = 1,688.
- Results: This study evaluated post-mastectomy radiotherapy (PMRT) in patients with intermediate-risk breast cancer (pT1-2, N1). At 10 years, there was no significant difference in overall survival between patients receiving chest-wall irradiation and those who did not. These findings support the safe omission of PMRT in selected patients with favorable biology.
Skagen Trial 1
- Design: Phase III Randomized Controlled Trial.
- Patients: N = 2,963.
- Results: This trial compared hypofractionated loco-regional radiotherapy (40 Gy in 15 fractions) versus conventional fractionation (50 Gy in 25 fractions). The 15-fraction schedule was proven non-inferior for loco-regional control and overall survival. Crucially, it demonstrated significantly lower rates of late toxicity, including lymphedema, establishing the 3-week regimen as a standard of care.
EUROPA Trial
- Design: Phase III Randomized Controlled Trial.
- Patients: N = 731.
- Results: Comparing radiotherapy alone versus endocrine therapy alone in women aged over 70 with low-risk Luminal A breast cancer, the study showed that radiotherapy alone resulted in superior Quality of Life at 2 years. Important Note: While QoL outcomes favor radiotherapy, data regarding long-term local control and recurrence rates are still pending.”
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