When is it necessary to boost the chest wall scar post-mastectomy?

Theres is no easy answer to this question, and utilization of scar boost varies across institutions based on preferences and interpretation of scant data. Notably, the original ASCO guideline on PMRT explicitly stated that there was insufficient data to say anything about using a scar boost (Recht, ...

This has never been established prospectively. Based on retrospective data, I would say that patients with inflammatory or locally advanced breast cancer with a poor response to primary chemotherapy or those with a close/positive margin are the ones who would possibly benefit from a chest wall scar ...

As a rule, I have never boosted the scar, since it's unclear why the scar would be at any higher risk than the rest of the chest wall. Frequently, the scar isn't even close to where the primary was located.

In 30+ years of practice, I don't think I've seen a scar failure, although I'm sure this has...