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How do you approach boost to the lumpectomy cavity AND 4 lymph nodes with extra-nodal extension when treating breast cancer with hypofractionation?

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Mednet Member
Mednet Member
Radiation Oncology · Allegheny Health Network, Pittsburgh

For breast/chest wall + RNI, I have transitioned to moderate hypofractionation giving 40 Gy/15 fractions. I don't see a clear role for standard fractionation; with 4+ nodes, the question is ALND but if you are giving RT, I'm not sure I see that as an indication for standard fractionation.

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