Historically, IBC is traditionally treated with trimodality therapy to include PMRT with comprehensive regional nodal irradiation (RNI). However, given increasing interests in treatment de-escalation of carefully selected patients throughout various disease sites, including IBC (Fayanju et al. 2020), are there any IBC patients for which you would consider omitting full/partial nodal coverage?

Do you comprehensively cover all nodal basins (i.e. dissected+undissected axilla, SCV, IMN) regardless? What factors, if any, would influence you to deviate from this paradigm? Hormone-receptor/Her2 status? Presence of residual primary tumor? Patient-related factors for high lymphedema risk (i.e. obesity, # LNs removed, wound issues, poorly controlled DM, etc)?