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Topics:
Breast Cancer • Radiation Oncology
Do you offer RNI to a T1N0 breast cancer patient who underwent inadequate axillary dissection?
If a SLN biopsy could not be performed and only a few lymph nodes were removed by ALND that were negative, would you treat the nodes? What factors would influence your decision (LVSI, triple negative, gr 3, etc)?
Answer from: Radiation Oncologist at Community Practice
I would not do RNI but include level 1 and 2 nodes for inadequate assessment of axilla with a tangential field for BCS.
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Answer from: Radiation Oncologist at Community Practice
In patients undergoing mastectomy who are T1N0 with inadequate axillary sampling (no SLN, few LN taken), I do not offer RT even with triple-negative, grade, LVSI unless positive margin though I do discuss the possibility of higher rates of LRR than a luminal A patient.
In patients undergoing lumpec...
Answer from: Radiation Oncologist at Community Practice
In the name of playing Devil's Advocate (or initiating a nerd fight club), I'll provide an opposition view on "is it ever appropriate to cover RNI for pT1N0?" (irrespective of LND adequacy, & excluding neoadjuvant therapy).Situations for data suggest which it may be reasonably considered/discuss...
Answer from: Radiation Oncologist at Community Practice
Covering Level I and II are sufficient.
Answer from: Radiation Oncologist at Community Practice
@John M. Watkins @Sushil Beriwal @Chirag S. Shah. I have a case along a similar topic that I would love your thoughts on:
The patient is a female in her late 20s with left breast IDC, strongly ER+ PR+ Her2-, poorly differentiated of lower outer/central quadrant, 5:00 5 cm FN. Upfront breast MR with...
Comments
Radiation Oncologist at Varian Medical Systems/Allegheny health network
I would not favor RNI
I would not favor RNI
Radiation Oncologist at Mallory Radiotherapy, PLLC
Agree and I would not favor protons, either.
Agree and I would not favor protons, either.