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?

Answer from: Radiation Oncologist at Academic Institution

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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Radiation Oncologist at West Virginia University
It's surprising to me that you comment you are exp...

Answer from: Radiation Oncologist at Academic Institution

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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In what circumstances would you offer axillary re-irradiation after salvage axillary dissection?

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