Dr. Mamounas Study Findings Published in the New England Journal of Medicine

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  • AdventHealth Research Institute
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Used after breast surgery, regional node irradiation (RNI) is generally a standard part of treatment for patients with pathologically positive axillary nodes and aims to reduce the risk of cancer recurrence by killing any remaining cancer cells in those nodes. However, with the increasing use and efficacy of neo-adjuvant chemotherapy, many patients who initially present with positive axillary lymph nodes become pathologically tumor free after neoadjuvant chemotherapy. The benefit of RNI in this population of patients was unclear.

The phase III, multicenter, randomized NSABP B-51-RTOG 1304 clinical trial explored that question. The results were recently published in the New England Journal of Medicine with Eleftherios “Terry” Mamounas, MD, medical director of the breast program and research activities at AdventHealth Cancer Institute, serving as lead author. The study found that patients with positive axillary lymph nodes who become pathologically tumor free after neoadjuvant chemotherapy have low rates of disease recurrence and do not receive a statistically significant or clinically meaningful benefit from RNI at 5 years, supporting a shift in treatment strategy.

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