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Would you give/omit regional nodal irradiation in low nodal burden ER- Her2+ disease s/p BCS with SLNB?

e.g. Gingras et al., JNCI 2017, a secondary analysis of the ALTTO trial?
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How do you manage low nodal burden ER-/Her2+ disease with RTafter lumpectomy?

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1 Answer
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Allegheny Health Network, Pittsburgh
Answered on

When I evaluate patients in this situation, BCS + SLN with positive node, I tend to think about the decision as to the whole breast RT+/- RNI and use AMAROS/Z011 to frame my decision making.

In an ER-negative patient, I would favor RNI, extrapolating from MA20 (where patients had an ALND, and 85% 1-3...

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