Would you employ high tangent fields for a sentinel node biopsy with isolated tumor cells (ITCs)?
In hormone receptor-positive early-stage breast cancer (patient <65 years of age) with a sentinel lymph node biopsy showing isolated tumor cells (ITC+) only, is there a role for high tangent fields to cover the low axilla, given the absence of randomized, high-level evidence specifically addressing this population?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
For ITCs, I would favor treating it like a node-negative approach. So I would also offer APBI if suitable; otherwise. If doing whole breast, part of the low axilla gets some RT, but don’t chase it.
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Mednet MemberInvited Expert
Radiation Oncology · Cooper Medical School of Rowan University/Cooper University Hospital
Answered on
"Ahhhh..."High Tangents". They're different than "Regular Tangents", you know....You see, your superior border is abutting the humeral head, so that's "High Tangents"....but if I put my two fingers together and lay them on the film like *this*...and then draw a little wax line like *this*....then we...
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