How does a pathologic CR to neoadjuvant chemotherapy influence your practice for the use of bolus with adjuvant PMRT patients without inflammatory breast cancer, but who would meet traditional risk factors for skin involvement?  

For example, if there was radiographic evidence of skin thickening or a punch biopsy showing dermal invasion pre-chemo, but a complete pathologic response post chemo at the time of surgery would you still recommend use of bolus? Mastectomy scar or the whole tangent field?