What risk/pathologic factors merit PMRT for a patient with recurrent breast cancer and a prior history of ipsilateral breast irradiation?
If the patient has evidence of axillary lymphadenopathy on imaging, would that change your approach to treatment?
Would response to neoadjuvant chemotherapy change your decision making process?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on · Updated on
My threshold for reradiation PMRT is higher. Would do for upfront 4 or more positive node or persistence of nodal disease after chemotherapy. If there is complete response to chemotherapy, then would avoid PMRT unless inflammatory breast cancer.
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · Allegheny Health Network, Pittsburgh
Answered on
With respect to PMRT following previous radiation, I consider for inflammatory recurrence, positive margins, ECE.
If the patient has not had previous RNI, can consider for node positive. If previous RNI, my threshold is higher given concerns regarding lymphedema, plexopathy.
Join for free or sign in to see the full answer