How would you treat an isolated ipsilateral axillary recurrence in a BRCA+ HR+ HER2+ breast cancer?  

BRCA mutant, ER/PR positive and HER2 positive T2N0M0 breast cancer diagnosed 5 years ago, treated with bilateral mastectomy, BSO, 1 year of adjuvant anti-HER2 therapy on adjuvant endocrine therapy for nearly 5 years, and now has ipsilateral axillary recurrence. Restaging scans negative for systemic disease and the axillary node resected and again triple positive. Radiation naive.



Answer from: Medical Oncologist at Academic Institution