For postmastectomy patients who have >2 sentinel nodes involved, would you recommend a completion axillary dissection or proceed with PMRT?

Answer from: Radiation Oncologist at Academic Institution

This is a question that is still debated. I am comfortable extrapolating AMAROS/Z011 to mastectomy patients despite the limited number of patients undergoing mastectomy in AMAROS.In patients with 2-3 SLN involved (that were cN0), I would be ok with PMRT and omitting ALND as long as no ECE. If > 3...

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Radiation Oncologist at Weill Cornell Medical College
Agree

Radiation Oncologist at Christus St Vincent
With the same cNo patient with 2-3 nodes positive ...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
RNI

Radiation Oncologist at UNC School of Medicine
I would tend to use a traditional formal SC and Ax...

Answer from: Radiation Oncologist at Community Practice

The rationale for dissection for > 2 node positive (clinical trials limiting to 1-2 node) is to some extent, based on the risk of additional node being high and RT may not be sufficient. Like in Z11 and AMAROS, the risk of additional nodes was 27-33% and for that subset, RT is sufficient. Recent ...

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Radiation Oncologist at Mon Health
Thank you.

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For postmastectomy patients who have >2 sentinel nodes involved, would you recommend a completion axillary dissection or proceed with PMRT?

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