EBRO 2017

Regional treatment: DBCG-IMN trial

2000 Anthracyclines

Internal mammary nodes (IMN) Known reservoir for occult metastases No consensus on adjuvant radiotherapy

2003

No evidence for effect of IMN-RT

Right side + IMN RT

?

Left side No IMN-RT

1990’s Increased awareness

DK: 1980’s IMN RT for all N+ breast cancer patients

Left side heart dose high

on RT-induced heart disease

Thorsen LBJ, et al. J Clin Oncol. 2016 Feb 1;34(4):314-20, courtesy Dr Offersen .