In patients receiving PMRT do you perform a boost if they have had reconstruction (tissue expanders,…)?  

Ideally I think we should make treatment recommendations prioritizing the clinical features over the reconstructive approach.  The benefit of the scar boost after mastectomy is unclear, and the target for the boost is also unclear, so I tend to reserve the boost for patients with multiple high ...

We, in general, don't boost the scar if they have had reconstruction. That being said, if the pathology shows close or positive margins, then we do consider a quadrant boost in these patients.

In our practice at MD Anderson, there is a long history of delivering a boost to the chest wall flaps using appositional electrons. Our published local-regional failure rates are quite low, approximately 2-3% at five years, which has made the group somewhat reluctant to abandon this practice. The co...

I have never boosted the scar, since that's not an area at risk and have never seen a scar recurrence. On the other hand, it can sometimes cause issues with the implant, possibly leading to failure, especially in smokers with poor vascularity to begin with.