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Regional nodal irradiation improves outcomes for patients with involved axillary lymph nodes. It is indicated for patients with extensive nodal involvement and for patients with fewer (1–3) involved axillary nodes in the presence of adverse prognostic factors, irrespective of the administration and the sequence of adjuvant systemic treatment. In case of limited axillary involvement on sentinel lymph node biopsy (SLNB), regional node irradiation is preferred to axillary dissection. Regional node irradiation should comprise all nodal target volumes, excluding the part of the axilla that was removed by axillary dissection, including the internal mammary nodes especially in case of centrally or medially located tumours. Contemporary regional node irradiation, based on individualised radiation therapy planning based on the ESTRO guidelines for target volume contouring, has a low risk of toxicity.

Original publication





Book title

Breast Cancer Radiation Therapy: A Practical Guide for Technical Applications

Publication Date



341 - 346