Network-based classification of breast cancer metastasis
Several decisions regarding local therapy are necessary for patients found to have pathologically involved lymph node s. Published literature and current guidelines are reviewed, with emphasis on controversial topics such as regional nodal and postmastectomy radiation therapy for patients with one to three positive nodes. Choice of field design in patients undergoing radiation therapy will also be highlighted. Unique clinical situations such as locoregional treatment in patients receiving neoadjuvant chemotherapy and the emerging role of tumor biology and molecular assays in local therapy decision making will also be discussed. Among patients with breast cancer, ipsilateral regional nodal status carries strong and independent prognostic value.
