NCIC MA.20
MA.20, published alongside EORTC 22922, showed that adding nodal irradiation after lumpectomy improves disease-free survival, mainly by preventing distant spread, without a survival difference at ten years.
Overview
MA.20 randomised 1,832 women with node-positive or high-risk node-negative breast cancer treated by breast-conserving surgery and systemic therapy to whole-breast irradiation with or without regional nodal irradiation. Ten-year disease-free survival was 82.0 percent with nodal irradiation and 77.0 percent without (hazard ratio 0.76); overall survival did not differ (82.8 versus 81.8 percent), and lymphoedema and pneumonitis were more frequent (Whelan and colleagues, New England Journal of Medicine 2015).
- 82 vs 77 out of 100 alive without the cancer coming back at 10 years with Whole breast plus nodal irradiation compared with Whole-breast irradiation alone; 5 more per 100.
- Roughly one extra person helped for every 20 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- These results apply to the people the trial enrolled: Node-positive or high-risk node-negative breast cancer after breast-conserving surgery: whole-breast irradiation with or without regional nodal irradiation. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
1,832 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Disease-free survival at 10 yearsprimary | Whole breast plus nodal irradiation | 916 | 82% | - | - | - |
| Whole-breast irradiation alone | 916 | 77% |
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