Please select the option that best describes you:
How would you manage an isolated nodal recurrence of breast cancer in a patient with a prior history of mantle-field radiation?
What dose/target volumes would you consider for an isolated nodal recurrence s/p en-bloc excision in a patient with a history of mantle radiation >30 years ago for Hodgkin lymphoma who had a subsequent radiation-induced breast cancer managed with mastectomy and reconstruction?
Is there a re-irradiation regimen that should be considered for post-mastectomy chest wall/regional node fields in the setting of prior mantle radiation for a locoregionally recurrent breast cancer in a PMRT-naive patient?
Answer from: Radiation Oncologist at Academic Institution
Nodal recurrences, especially in unresectable regions, are especially challenging cases in the context of reRT. At a high level, the first thing to think about is resectability. If resectable, the usual approach is surgery, then adjuvant RT to unirradiated areas, and adjuvant chemotherapy. If unrese...
Sign In or Register to read more
Answer from: Radiation Oncologist at Academic Institution
The clinical details of the patient's "initial" radiation-associated breast cancer and what adjuvant treatment(s) she received after her mastectomy and reconstruction would be helpful here, both in determining the risk of the nodal recurrence she has now experienced and what additional therapies she...
Answer from: Radiation Oncologist at Community Practice
Since en-bloc excision has been done, I would favor RT for microscopic disease to the chest wall, regional nodes, including IMN, respecting heart and brachial plexus constraints. Dose 1.2 or 1.5 Gy BID to 45 Gy EQ2 or so.