How would you design chest wall boost in a patient who underwent mastectomy with a Wise-pattern incision?

Our breast surgeons are increasingly using Wise-pattern mastectomy for improved cosmetic outcomes. Expanding the scars by 2 cm, especially along the inframammary incision, doesn't seem to make the most sense. In a patient who has clearly indication for boost, for example, young age, extensive LVSI, triple negative, close margin, what would be a reasonable boost field?

Answer from: Radiation Oncologist at Academic Institution

Great question. We've all dealt with this scenario clinically. I'll first point out that there is no prospective data for use of chest wall boost in the post-mastectomy setting. The most common location of recurrence following mastectomy is the flap skin, and the most common subsite, but not always,...

Comments

Radiation Oncologist at Washington University School of Medicine
The above recommendation is correct. The question ...

Radiation Oncologist at University of Colorado School of Medicine
Thank you Dr. @Carlos A. Perez! These are great ab...

Radiation Oncologist at Washington University School of Medicine
I completely agree with Dr. @Rachel A. Rabinovitch...

Radiation Oncologist at Prairie Lakes Healthcare System
I generally boost if it was a high-grade tumor, ma...

Radiation Oncologist at Rush University Medical Center
I find this conversation interesting in light of t...

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How would you design chest wall boost in a patient who underwent mastectomy with a Wise-pattern incision?

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