Postoperative nodal irradiation in breast cancer patients with 1 to 3 axillary lymph nodes involved: the debate continues….

Regional lymph node irradiation is usually indicated in patients with positive node breast cancer. However, there are some controversies regarding the clinical benefits of adding regional nodal irradiation to whole-breast or thoracic-wall irradiation after breast surgery especially for patients with 1 to 3 positive axillary lymph nodes. More recently, two important studies (NCIC MA.20 and EORTC 22,922-10925) were published to address this significant issue and some further points need to be discussed.