Does microscopic ENE warrant post-mastectomy radiotherapy if all other factors are low risk?
For example, in a patient with T1 disease and 1/1 node involved with a micromet and focal ENE.
Would your recommendation change if the patient were receiving chemotherapy?
Would you consider treating the lymph nodes alone to avoid reconstruction complications?
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Allegheny Health Network, Pittsburgh
Answered on
With respect to ENE, I first look at axillary surgery. If the patient has SLN+ and microscopic ENE, I do typically offer PMRT even with other low-risk factors. While the IBCSG trial evaluates micrometastases, it's important to remember 90% received lumpectomy, and therefore, most received whole breast RT. As such, I favor PMRT in micromet with ENE with SLN.
If ALND, I discuss pros/cons and consider PMRT based on number of nodes, LVSI, receptor status.
If I treat, I treat CW and nodes and do not tr...
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