Is it reasonable to offer APBI in an obese patients with large breasts and N1mi disease?
For a patient with an ER-positive, pT1c breast cancer who otherwise meets criteria for APBI, but has a BMI of 50 with pendulous breasts and N1mi disease, how would you approach adjuvant radiation treatment?
To what extent do you feel there would be a compromise in local control with partial breast in this clinical scenario, and do you feel that would outweigh any decrease in toxicity afforded by APBI?
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
Most published data with micromets and no nodal RT (most are small series) show a risk of regional recurrence is very low and varies from 0 to 5%. For that reason, micromets would not be contraindications to APBI because if the same patient has a mastectomy done, we would not offer any RT for node.
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