How would you manage a patient with locally advanced triple negative breast cancer s/p MRM, who refuses adjuvant chemo?

These are challenging situations. While the patient is refusing adjuvant chemotherapy, sometimes patients will consider concurrent Xeloda. If they will, I would give 50 Gy to wide post-op field (CW + RNI) and with areas of gross disease (ex. SCV, IM, retrosternal) boosted to 66 Gy.

If the patient r...