Regional Nodal Irradiation in the Modern Era of Breast Cancer Management

Management of the axilla has undergone a tremendous evolution in recent years. Although surgery has become progressively less invasive, data supporting a larger role and extent of regional nodal irradiation (RNI) have grown. For example, the AMAROS trial (After Mapping of the Axilla Radiation or Surgery) demonstrated that axillary radiation therapy (AXL-RT) can be used as an alternative to completion axillary lymph node dissection (cALND) in node-positive patients, yielding extremely low rates of axillary recurrence and less morbidity than surgical resection (1).

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