Prof Ian Kunkler speaks to ecancer about the 10-year BIG 2-04 MRC SUPREMO randomised trial results.

This phase 3 trial investigates the impact of adjuvant chest wall irradiation following mastectomy and axillary surgical staging with operable breast cancer at 'intermediate risk' of loco-regional recurrence.

Two previous studies suggested that adding local, regional irradiation to systemic therapy improves survival rates for high-risk patients.

However, concerns about trial quality arose.

This trial assessed chest wall irradiation combined with modern systemic therapy.

Results showed no significant difference in overall survival after 10 years among 1,607 patients, indicating that chest wall irradiation may be unnecessary for certain patients despite a slight reduction in local recurrence rates.