In a patient who is planned for WBRT for multiple brain metastases but also needs breast palliation, do you favor breast radiation over palliative mastectomy?  

Why not concurrent? 30/10 to both. Can add a few more to breast, sometimes I go to 39 Gy/13 fx. If not concurrent (why, though?), then just depends on which seems more bothersome. The breast has probably been there for quite a while, so perhaps address brain and then re-assess.

Yes, I would favor breast radiation, and probably 30 Gy in 10 fx for both is reasonable, and I would offer it concurrently to save the patient time if your machine schedule allows. If this is her initial presentation, then the breast may improve with systemic therapy only. However, 30 Gy for a large...