In what circumstances would you offer axillary re-irradiation after salvage axillary dissection?
In a patient with history of early stage breast cancer pN+(sn) treated with BCS + RT with RNI who develops isolated axillary recurrence years later, would you offer axillary re-irradiation after salvage axillary dissection?
Would this depend on number of nodes positive?
What regimens would you consider?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Beth Israel Deaconess Medical Center
Answered on
A study from many years ago found no further axillary recurrences in 4 patients who had gross total excision of axillary recurrences following initial breast-conserving therapy, including RT and axillary dissection, with a median follow-up of 28 months (Recht et al., PMID 2033433). However, there is...
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Mednet MemberInvited Expert
Radiation Oncology · Cedars-Sinai Medical Center
Answered on
This is a tough situation, but one that we encounter more often than we would like!
Although there have been studies examining conventional fractionation to 45-50 Gy in the re-irradiation setting [to the chest wall (post-mastectomy) and/or regional nodal regions], in the axillary re-irradiation setti...
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