1590 / 1983
Regional treatment: DBCG-IMN trial
DK: 1980’s
IMN RT for all N+
breast cancer patients
1990’s
Increased awareness
on RT-induced
heart disease
2000
Anthracyclines
?
Right side
+ IMN RT
Left side
No IMN-RT
2003
No evidence for
effect of IMN-RT
Left side
heart dose high
Internal
mammary
nodes (IMN)
Known
reservoir for
occult
metastases
No consensus
on adjuvant
radiotherapy
Thorsen LBJ, et al. J Clin Oncol. 2016 Feb 1;34(4):314-20, courtesy Dr Offersen
.