How do you manage early stage breast cancer patients with suspicious internal mammary nodes on imaging?

If a patient has T2N0 disease without LVSI, but has a ~4 mm IMN node in the 4th or 5th intercostal space, would you be inclined to include the IMN chain in your tangents and add on a boost to the suspicious node? If so, how much of the chain would you cover?

Answer from: Radiation Oncologist at Academic Institution

In patients with a suspicious IMN, who are getting BCT, I would: a. Include the IMN chain in the target volume and give it the same dose as the breast is getting. b. Boost the IMN suspicious area to a dose that would reasonably sterilize that node. In the era of 2 Gy per fraction, that typical...

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Radiation Oncologist at Coastal Radiation Oncology
I think I would want a bit more information before...

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How do you manage early stage breast cancer patients with suspicious internal mammary nodes on imaging?

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