A 46-year-old woman undergoes modified radical mastectomy for a 5 cm invasive ductal carcinoma with 4 of 15 axillary nodes involved. Her oncologist adds adjuvant therapy beyond systemic chemotherapy and endocrine treatment. Which intervention has been shown to reduce locoregional recurrence in this setting?
- A Postoperative radiotherapy to the chest wall and draining regional nodes ✓
- B Completion level III axillary clearance
- C High-dose chemotherapy with autologous stem cell rescue
- D Adjuvant bisphosphonate therapy alone without further local treatment
Correct answer: A. Postoperative radiotherapy to the chest wall and draining regional nodes
Explanation
Involvement of four or more axillary nodes, or a primary tumor of 5 cm or larger, is an accepted indication for post-mastectomy radiotherapy to the chest wall and regional nodes, which reduces locoregional recurrence and improves survival. Further axillary clearance adds morbidity without proven benefit once level I and II nodes are removed.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.