How would you manage a patient with a prior history of an ER+/PR+ breast cancer s/p mastectomy who develops nodal recurrence 2 years after surgery?
The patient did not have radiation previously, but now has recurrent disease in Axillary levels 1-3, supraclavicular nodes, and IMN in the first intercostal space
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
If a candidate for neoadjuvant chemo then chemo first, followed by ALND, and then comprehensive PMRT with nodal boost to all undissected nodes to 60 to 66 Gy based on response and residual nodal size.
If not a candidate for chemo then AI with CD4/6 inhibitor for downsizing and similar to above for l...
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