In a patient with favorable risk pT1N0(mic/i+) breast cancer and favorable anatomy, would you use IMPORT-LOW style PBI while incorporating the high axilla?

The patient is pT1c ER+/PR+/HER2- grade 1 IDC, LVSI-, N0(i+) with an upper outer cavity and a ~29cm breast separation

If the cavity location is such that an IMPORT-LOW style mini-tangent could actually incorporate the partial breast target and high axilla by raising the upper field edge. Would you feel comfortable taking this approach, or would you convert to whole breast RT with high tangents?

Answer from: Radiation Oncologist at Academic Institution

For N0(i+), PBI is appropriate, I would not include axilla. 40/15, 30/5. If N1mic, would not use PBI but would favor WBI, high tangents if ER+, RNI if ER-.

Comments

Radiation Oncologist at Rush University Medical Center
When one goes through the literature regarding bra...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
None of the modern studies with dose per fraction ...

Answer from: Radiation Oncologist at Community Practice

I would treat like node negative and IMPORT LOW without axilla or APBI like levy; both reasonable options.I would prefer APBI as less exposure and thus less side effects in large breast size compared to IMPORT LOW.

Please select the option that best describes you:

In a patient with favorable risk pT1N0(mic/i+) breast cancer and favorable anatomy, would you use IMPORT-LOW style PBI while incorporating the high axilla?

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