Two recent randomized clinical trials from Denmark and Canada show that postoperative radiotherapy of breast cancer patients in whom the findings revealed a high risk of dying from the disease not only causes improvement of the locoregional tumour control but also prolongs survival. However, this does not establish definitely which patients belong to this 'high risk category'. Results of retrospective studies from Leiden suggest that selective withholding of postoperative radiotherapy in the Netherlands is justified for large groups of breast cancer patients. Both clinically manifest parasternal recurrences and axillary recurrences are rare among these patients. The condition is, however, that the axillary dissection is radical and performed properly.
Comment On: Ned Tijdschr Geneeskd. 1999 Jan 9;143(2):71-310086106