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Previously, only women with 10 or more positive nodes, a very advanced cancer, were routinely given radiation, he said.
"Almost overnight, following these consensus conferences, the majority of the country switched to radiating women with four or more positive nodes," Dr. Borgen said.
5 The presence of 4 or more positive nodes disqualified a patient as ELIOT Low Risk.
Most patients had 10 or more positive nodes at initiation of adjuvant therapy.
Patients who benefit most from axillary clearance are those with four or more positive nodes.
In the ELIOT Trial patients were stratified as N0, 1 3 positive nodes, or 4 or more positive nodes.
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The N stage categories are N1 (1–2 positive lymph nodes), N2 (3–6 positive lymph nodes), and N3 (7 or more positive lymph nodes).
The spread of breast cancer to locoregional lymph nodes was categorised as negative, one to three positive lymph nodes and four or more positive lymph nodes.
Adjuvant axillary radiotherapy was performed in patients with four or more positive lymph nodes in the axillary node clearance and in all T3 and T4.
For patients with HR+/HER2- disease, the five-year LRR-free survival rates were 93%and98%8%, respectively, for those who had four or more positive lymph nodes versus those who had zero to three positive nodes.
Patients with positive lymph nodes larger than 3 cm, three or more positive lymph nodes, and/or extranodal growth pattern received adjuvant radiotherapy (45 60 Gy).
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