Patients with axillary lymph node metastases from an unknown primary breast cancer are recommended to receive radiation therapy to the breast containing the lymph nodes in order to reduce the risk of local cancer recurrence. A study found that radiation to the affected breast is as effective as mastectomy in controlling the cancer locally and has better cosmetic outcomes by preserving the breast. Higher doses of radiation did not provide significantly better local control and risk additional side effects, so standard dose radiation is recommended.

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Ipsilateral breast radiotherapy in patients with occult primary breast cancer
presenting with axillary metastases
Patients with axillary lymph nodes metastases from an occult primary breast cancer are
recommended treatment to the ipsilateral breast following axillary surgery to reduce the risk
of local relapse. Our study provides further evidence that radiation to the ipsilateral breast is
a safe alternative to mastectomy, to which it is favourable given the cosmetic advantages of
conserving the breast. No significant improvement in local control was seen using higher
doses of radiotherapy than standard dose. Because of the risk of additional toxicity with
increasing dose, standard dose radiotherapy is recommended
Bibliographic Reference:
Barton SR et al.: "The role of ipsilateral breast radiotherapy in management of occult primary
breast cancer presenting as axillary lymphadenopathy", Eur J Cancer. 2011 Jun 7. [Epub
ahead of print]
Marina Parton
Breast Unit, The Royal Marsden Hospital and Institute of Cancer Research, Fulham Road,
London SW36JJ, UK
http://www.senology.org/Edit_Parton.htm 04/10/2011