How would you treat a large-cell neuroendocrine carcinoma of the breast with bulky axillary involvement with good response to neoadjuvant chemo followed by mastectomy/ALND?

Would you consider traditional breast doses or higher? Would you consider treating only the axilla if the mastectomy specimen showed widely-negative margins?

2 Answers

Mednet MemberInvited Expert

Radiation Oncology · Varian Medical Systems/Allegheny health network

Answered on

I would favor comprehensive treatment as uncommon disease and has poor outcome and would err on side of over treatment

Mednet MemberInvited Expert

Radiation Oncology · Allegheny Health Network, Pittsburgh

Answered on

Agreed, I would treat comprehensively. In terms of dose, not much data but I would use standard doses unless concerns for gross or microscopic disease, though in this case margins are widely negative.