{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:52:29Z","timestamp":1782121949049,"version":"3.54.5"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CA A Cancer J Clinicians"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    European Organization for Research and Treatment of Cancer trial EORTC 22922\/10925 evaluated internal mammary and medial supraclavicular (IM\u2010MS) lymph node irradiation (IM\u2010MS\u2010RT) in patients with stage I\u2013III breast cancer. Eligible patients had involved axillary nodes and\/or centrally\/medially located tumors regardless of nodal involvement. The primary end point was overall survival, secondary end points were disease\u2010free survival, distant metastases\u2010free survival, breast cancer mortality, and any breast recurrence. Between 1996 and 2004, 4004 patients were randomized. The median patient age was 54 years. At a median follow\u2010up of 22.2 years, 1550 (38.7%) patients died, of whom 796 (51.4%) died from breast cancer. At 20 years, the overall survival rate was 61.8% in the control group versus 61.0% in the IM\u2010MS\u2010RT group (hazard ratio [HR], 1.00;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.967); the disease\u2010free survival rate was 49.0% versus 48.2%, respectively (HR, 0.97;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.515); and the distant metastases\u2010free survival rate was 59.8% versus 58.9%, respectively (HR, 0.97;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.578). The breast cancer mortality rate was 22.4% in the control group and 18.6% in the IM\u2010MS\u2010RT group (HR, 0.82;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.006), whereas the rate of deaths not from breast cancer or from unknown causes was 15.8% versus 20.4%, respectively (HR, 1.26;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.002). Lung fibrosis, cardiac fibrosis, and cardiac diseases were more frequent after IM\u2010MS\u2010RT versus no IM\u2010MS\u2010RT (6.3% vs. 3.2%, 2.7% vs. 1.7%. and 15.2% vs. 11.7%, respectively); and the rates of severe cardiac and lung morbidities (scores of 3 or 4) were 1.9% versus 1.7% and 0.3% versus 0.0%, respectively. Breast cancer mortality at 20 years was statistically significantly lower after IM\u2010MS\u2010RT, but deaths not from breast cancer increased after 15 years, resulting in no long\u2010term benefit of IM\u2010MS\u2010RT on overall survival. Therefore, the authors strongly call for very long\u2010term follow\u2010up of treatments for prognostically favorable cancers such as breast cancer.\n                  <\/jats:p>","DOI":"10.3322\/caac.70082","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T10:20:14Z","timestamp":1778926814000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Twenty\u2010year results of the randomized European Organization for Research and Treatment of Cancer trial 22922\/10925 evaluating internal mammary chain and medial supraclavicular lymph node irradiation in stage I\u2013III breast cancer"],"prefix":"10.3322","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-1869","authenticated-orcid":false,"given":"Orit","family":"Kaidar\u2010Person","sequence":"first","affiliation":[{"name":"Breast Radiation Unit Sheba Medical Center  Ramat Gan Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-7151","authenticated-orcid":false,"given":"Caroline G.","family":"Weltens","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Leuven  Leuven Belgium"},{"name":"Laboratory of Experimental Radiation Oncology Katholieke Universiteit te Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Fortpied","sequence":"additional","affiliation":[{"name":"European Organization for Research and Treatment of Cancer  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6690-6118","authenticated-orcid":false,"given":"Luc J. 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