Overview
Malignant neoplasms can arise following immunosuppressive therapy. This summary focuses on the management of breast cancer, specifically the role of postmastectomy radiation therapy (PMRT) in patients treated with systemic therapy.
Management
Postmastectomy radiation therapy (PMRT) is recommended after neoadjuvant systemic therapy for patients presenting with locally advanced disease 1.
PMRT is also recommended after neoadjuvant systemic therapy for patients with residual nodal disease at the time of surgery 1.
PMRT is conditionally recommended for patients with cT1-3N1 or cT3N0 breast cancer with pathologically negative nodes after neoadjuvant systemic therapy (ypN0) 1.Key Recommendations
Postmastectomy radiation therapy (PMRT) is indicated for most patients with node-positive breast cancer after upfront mastectomy 1. (Evidence: Moderate)
PMRT is recommended after neoadjuvant systemic therapy for patients presenting with locally advanced disease and for those with residual nodal disease at the time of surgery 1. (Evidence: Moderate)
PMRT is conditionally recommended for patients with cT1-3N1 or cT3N0 breast cancer with pathologically negative nodes after neoadjuvant systemic therapy (ypN0) 1. (Evidence: Moderate)References
1 Jimenez RB, Abdou Y, Anderson P, Barry P, Bradfield L, Bradley JA et al.. Postmastectomy Radiation Therapy: An ASTRO-ASCO-SSO Clinical Practice Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2025. link