How would you approach a patient with metastatic breast cancer with extensive skin involvement?

Would you send the patient to a surgeon for consideration of a mastectomy? Would you then consider post mastectomy radiation when the risk of recurrence along the chest wall is high due to multiple positive margins? What dose would you use if the patient does not undergo surgery? How do hormone receptor status and prognosis affect these decesions?

1 Answer

Mednet MemberInvited Expert

Radiation Oncology · University of Miami Miller School of Medicine

Answered on

The issue of extensive skin involvement in metastatic breast cancer can be very challenging. Many factors come into play including whether the patient has had a mastectomy or has an intact breast as well as whether previous radiation has been delivered.

For a previously untreated intact breast: Surgical intervention could be considered. However, the patient must be evaluated by the surgeon who would determine if mastectomy is an option. Often, the surgeon may do biopsies of the skin surrounding the breast prior to surgery to determine if clear margins can be obtained. if clear margins cannot be obtained, it may be best to provide radiation.

For a previously radiated intact breast: Again, surgical intervention can be considered with the sa...

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