In the post-mastectomy setting, are there situations where only the regional nodes or targeted nodal basis are covered?
How should ECE influence radiotherapy in breast cancer?
For T1-2 patients with N1 disease after sentinel node biopsy alone and upfront mastectomy (grade 1-2, ER/PR+ HER2-, margins clear) when the only indication is measurable ECE (no free deposits in the axillary tissue). Axillary dissection seems overtreatment, as does full RNI-IMN, but no RT to the axilla seems undertreatment
3 Answers
Mednet MemberInvited Expert
Radiation Oncology · UNC School of Medicine
Answered on
Thanks for asking this question. People occasionally ask this.
- Essentially all of the trials that show a survival advantage with PMRT used comprehensive local-regional therapy. So, doing something other than both the chest wall and nodes would not be based on the available data.
- Cancer is sneaky, i...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
In the AMAROS study, they did allow regional nodal RT without treating the chest wall for a situation like this. In practice, I have avoided this unless morbidity is high like impact on reconstruction or it is in a reradiation setting.
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · Cooper Medical School of Rowan University/Cooper University Hospital
Answered on
Born too late to explore the earth, born too early to explore the stars, burn just in time to use 2024 technology to deliver treatment based on 1994-quality data.
Laying aside the "ECE" issue for a second, I think these are reasonable questions to ask in the era of modern systemic therapy. I think i...
Join for free or sign in to see the full answer