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?



Answer from: Radiation Oncologist at Academic Institution