S289
Clinical - Breast
ESTRO 2026
References: 1
Thorsen LBJ et al. Internal Mammary Node Irradiation in Patients With Node-Positive Early Breast Cancer: Fifteen-Year Results From the DBCG IMN study. JCO 2022.2 Nielsen AWM et al. Internal mammary node irradiation in 4541 node-positive breast cancer patients treated with newer systemic therapies and 3D-based radiotherapy (DBCG IMN2): a prospective, nationwide, population-based cohort study. Lancet Reg Health – Eur 2024.3 Thorsen LBJ et al. Quality assurance of conventional non-CT- based internal mammary lymph node irradiation in a prospective DBCG trial: the DBCG-IMN study. Acta Oncol 2013. 4 Refsgaard L et al. Quality assurance of internal mammary node irradiation in the DBCG IMN2 study. Radiother Oncol 2025. Keywords: Internal mammary node irradiation, Breast cancer Adjuvant ultra-hypofractionated radiotherapy for early-stage breast cancer: toxicity and quality of life results Katsiaryna Kharkauskaya 1 , Martina Cantarella 2 , Noemi Giannini 1 , Giovanni Gadducci 1 , Cecilia Trippa 1 , Paola Puccini 1 , Maria Grazia Trapanese 1 , Alessandra Gonnelli 1 , Fabiola Paiar 1 1 Radiotherapy, University of Pisa, Pisa, Italy. 2 Radiotherapy, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy Purpose/Objective: This multicentric observational study aimed to evaluate feasibility, safety, and quality of life (QoL) outcomes of adjuvant ultra-hypofractionated radiotherapy (26 Gy in 5 fractions) in patients with early-stage breast cancer after conservative surgery. Primary endpoints were acute and late toxicity; secondary endpoints included aesthetic outcomes, QoL, and identification of potential predictors of toxicity. Material/Methods: Digital Poster Highlight 2824 Fifty-eight patients with low-risk invasive breast cancer (pT1–T2, N0, ER+, G1–2) treated between May 2023 and October 2024 received 26 Gy in 5 daily fractions (5.2 Gy/fraction) using 3D conformal radiotherapy (3DCRT) without tumour bed boost, following the FAST-Forward protocol. Toxicities were graded according to CTCAE v5.0. Cosmetic outcomes were assessed using the Harvard/NSABP-RTOG scale and Breast Cancer Treatment Outcome Scale (BCTOS). QoL was evaluated through the Linear Analog Self- Assessment (LASA) at 1, 3, 6, and 12 months. Statistical analysis used ANOVA and Chi-square tests.
Conclusion: Internal mammary node irradiation significantly improved DM, BCM, and OS. Subgroup analysis revealed that the effect persisted in patients with only 1 macrometastatic lymph node. These data support the use of IMNI as standard of care in breast cancer patients with one or more axillary macrometastases.
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