RE: Regional Nodal Irradiation After Breast-Conserving Surgery for Early HER2-Positive Breast Cancer: Results of a Subanalysis From the ALTTO Trial

We congratulate Gingras et al. for their report on regional node irradiation (RNI) in the human epidermal growth factor receptor 2 (HER2)–targeted therapy era (1). They suggest that RNI has no impact on disease-free survival (DFS) in node-positive (N+), HER2-positive breast cancer (BC) patients treated with conservative surgery, axillary node dissection (ALND), and whole breast irradiation. These results reported in the anti-HER2 era contradict RNI data from the MA20 and EORTC22922 trials (2,3).

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