Would you consider PBI plus covering the regional lymph nodes for a LN+ breast cancer in the remnant of the axillary tail?

Topics: Breast Cancer • Radiation Oncology

If a patient had a stage I contralateral breast cancer and received bilateral mastectomies with implant reconstruction 2 decades ago and now has breast cancer in the remnant of the axillary tail with a positive node, what radiation fields would you use?

Answer from: Radiation Oncologist at Academic Institution

Was this patient cN0 and had a positive SLN or did they have an ALND? In the setting of a cancer following prophylactic mastectomy (sounds like the original cancer was contralateral) with a positive node, my preference would be to cover chest wall + RNI. I would say that PBI covering regional node...

Comments

Radiation Oncologist at Mon Health
I agree Dr. @Shah

Radiation Oncologist at University of Texas Health Science Center San Antonio MD Anderson Mays Cancer Center
Agree with Dr. @Chirag S. Shah's comments. Especia...

Radiation Oncologist at Anderson Regional Cancer Center
How would you approach the same scenario in a pati...

Radiation Oncologist at Cleveland Clinic
I think you have to weigh the pros of treatment on...

Answer from: Radiation Oncologist at Community Practice

I would need a lot more information to answer this question, though it has to be said regional nodes plus PBI is an unusual option. My targets could be “All or Nothing” depending on age, receptors, how the node was found (clinically, sentinelly), nodal extent, extent of staging, the ant...

Answer from: Radiation Oncologist at Community Practice

I have had to treat a patient with this exact clinical scenario. I treated the resection bed and adjacent level 1 and 2 axillary nodes with Univ of Florence protocol for APBI. She did well. A 3-4-year follow-up does show some mild skin hyperpigmentation and subcutaneous fibrosis at the axillary tail...

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