When would you recommend postmastectomy radiation to a male, status post mastectomy with 1/1 sentinel nodes with ITCs?

Upfront ITC is not an indication for PMRT unless indicated for T factor. ITC after chemo, would treat like node-positive with PMRT.

If T1-T2 with ITCs, I would not recommend PMRT. If T3 with ITCs, I would discuss the pros/cons and favor if ER-. If T4, I would recommend.

For those seeking reference data on the above question, here are a couple:

• Karam et al., PMID 24035330
• Mittendorf et al., PMID 25488970