Would you employ high tangent fields for a sentinel node biopsy with isolated tumor cells (ITCs)?

Several studies have found that patients treated with upfront total mastectomy and sentinel lymph node biopsy without PMRT or axillary lymph node dissection had very low rates of axillary recurrence or local-regional relapse. For example, the Dutch MIRROR study conducted from 1998-2005 enrolled pati...

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.

Mamtani et al., PMID 28429197

"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...