Do you ever treat a recurrent breast cancer with RNI alone rather than chest wall and RNI?
A patient presents with clinically node-positive cT2 grade 3 invasive breast cancer in the upper outer quadrant. The patient had breast RT to 50 Gy with a 10 Gy boost for DCIS in the upper inner quadrant of the right breast 8 years prior.
The patient recently underwent neoadjuvant dose dense chemotherapy followed by mastectomy revealing a 2 cm tumor with no LVSI, negative margins, but with 3 out of 13 lymph nodes positive.
Would you favor treating with CW and RNI or RNI alone in this instance?
2 Answers
Mednet Member
Radiation Oncology · West Virginia University
Answered on
As this is a de novo case and not a recurrence, it would be reasonable to treat the nodes and leave the chest wall alone given the small size, absence of LVI, and adequate margins.
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
Retreatment indications are not absolute and are a function of absolute benefit vs. morbidity. For the above case, I would favor comprehensive RT unless RT effects from previous RT or breast suggest high morbidity with chest wall RT.
Join for free or sign in to see the full answer