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Abstract Background: One of the most controversial issues regarding the post mastectomy radiotherapy (PMRT) is treatment of the internal mammary nodes. The data regarding the value of routine internal mammary nodal irradiation are limited and contradictory. Internal mammary nodal irradiation was used in the majority of trials of PMRT, including the two Danish and British Columbia Trials. In older studies, the incidence of internal mammary node metastases was approximately 10% in patients with a negative axillary dissection and 20% to 50% in patients with positive dissection. More recent studies tend to show lower risks of involvement. Aim of work: This study aims at determination of the role of internal mammary irradiation in the treatment of operable breast cancer and to establish the best technique for localization and irradiation of internal mammary lymph nodes associated with the least complications. Conclusion: The need of internal mammary radiation should be evaluated according to the improvement in the survival that can be gained. Chemotherapy has an important role in the high risk group of patients but data regarding its role in control of positive internal mammary nodes are deficient. Local control has its impact on survival. Internal mammary radiation adds to the control of internal mammary nodes in high risk group overriding its toxicity. |