| Postmastectomy radiation to the axilla
|
| Studies show that radiation to the axilla will increase lymphedema, so it should not be routinely performed. Data from the MD Anderson series (mastectomy with postOp chemoRx but no radiation as reported by Katz ONI May 2001:41) |
| Site | Percent |
| Chest Wall | 68% |
| SurpaClav Nodes | 40% |
| Axilla | 14% |
| Internal Mamm Nodes | 8% |
| Infraclavic Nodes | 7% |
| They noted that the risk of relapsing in the axilla if a dissection was performed was quite small (3% at 10 years) but higher in the undissected cases (8%/10years.) The risk factors were only significant in the undissected axilla as shown: |
| Risk Factor | Undissected Axilla | Dissected Axilla |
| 4 or more nodes + | 15% | 5% |
| > 20% of nodes involved | 14% | 5% |
| 2mm or more extranodal | 20% | 5% |
they conclude that only patients with undissected axilla and one of these risk factors should get the axilla radiated