How would you treat a patient with a prior history of an early-stage breast cancer who now has a 5 cm tumor in this ipsilateral breast with nodal involvement?  

One of the important things is the time from the original course of RT. The longer the time from the 1st course the fewer wound complications and toxicities we see. She now has cT3N1 (at least per discussion) triple negative breast cancer. A few options are given plan for mastectomy: If pCR, can...

The value of regional nodal irradiation (RNI) without breast or chest wall irradiation has never been tested in the modern era. However, most recurrences after neoadjuvant chemotherapy and mastectomy are on the chest wall, not in regional nodes, so that RNI by itself seems unlikely to improve overal...

In general, re-irradiation of the chest wall should be done cautiously, and I tend to favor mastectomy and a complete ALND alone. Should there be a recurrence say, on the scar line further down the line, local excision followed by potential PMRT at that time could be possible. However, there are a ...