How would you manage a patient with a prior history of an ER+/PR+ breast cancer s/p mastectomy who develops nodal recurrence 2 years after surgery?

The patient did not have radiation previously, but now has recurrent disease in Axillary levels 1-3, supraclavicular nodes, and IMN in the first intercostal space

Answer from: Radiation Oncologist at Community Practice

If a candidate for neoadjuvant chemo then chemo first, followed by ALND, and then comprehensive PMRT with nodal boost to all undissected nodes to 60 to 66 Gy based on response and residual nodal size. If not a candidate for chemo then AI with CD4/6 inhibitor for downsizing and similar to above for ...

Comments

Radiation Oncologist at Mon Health
Can we spare our patients the morbidity of an ALND...

Radiation Oncologist at Weill Cornell Medical College
In general, I agree. Doses above 60 Gy may be dif...

Radiation Oncologist at Iowa City Cancer Treatment Center
No need for ALND.

Please select the option that best describes you:

How would you manage a patient with a prior history of an ER+/PR+ breast cancer s/p mastectomy who develops nodal recurrence 2 years after surgery?

Related Questions