How do you approach breast RT in a patient with a recent history of ipsilateral thoracic irradiation?

When patients have two simultaneous cancers, it is necessary to carefully plan the treatment strategy from the beginning in order to maximize the chance of cure of both cancers with the minimum possible toxicity. It is not clear what kind of surgery this patient had for her breast cancer, nor why th...

It depends on the specifics of the case, such as anatomy and dose to the ipsilateral breast, but patients like this may be a candidate for accelerated partial, hypofractionated partial, or RTOG 1014 approach with good heart/lung sparing. With accelerated techniques, it may be reasonable to wait unti...

I do not see the dose that the L breast received or where the IDC of the breast is located in the L breast. Depending on the dose to the partial mastectomy site from the L lung radiation, she could receive TARGITed IORT if she declines a mastectomy. She fits the eligibility criteria for TARGIT-A: > ...

I have a similar situation coming up with a TN right breast patient in her 70s with >10 axillary nodes and enlarged IMNs with an unresectable right hilar typical carcinoid found on staging. She's had a clinical and radiographic CR after the KEYNOTE-522 regimen and is going for BCT. She will need rig...

Thank you everyone. I felt that some form of whole breast treatment (vs. PBI) was preferable, given her poor response to chemotherapy. She was actually quite receptive to a discussion of mastectomy and probably would have chosen this if we had met before her surgery.

Another option is proton therapy.