Would you offer FAST-Forward for a metastatic breast cancer patient with breast implants needing palliation of symptomatic breast lesions?

This is a common scenario.

If symptomatic and close to the surface/skin, I would favor 30/10-39/13 with 1 cm bolus to get skin dose where needed; I would be a bit concerned about 5.2 Gy/fraction and that amount of bolus.

If larger, deeper lesions that are causing symptoms, 26/5 is fine in my opinion...

I've had very good luck with 26/5 whole breast with an SIB to 30-35 (depending on proximity to skin) to gross disease with fractions given twice weekly (no bolus). Clinical responses have been excellent--even for fungating lesions--toxicity is low, and it's non-burdensome for patients. Others have a...

Not for implants but yes, I would consider FF for a palliative breast without foreign body and overt infection.

My preference is to offer 30/10 +/- 15/5 boost to residual disease a week later for palliative breast patients.

I agree with the answers above. Also, although not often considered for breast, I have used quad shot several times in patients with poorer functional status with really good success for stopping bleeding and drainage and helping with pain. It's not overly burdensome for them. I just get off of brac...