In patients with history of prior axillary surgery, subsequently with breast cancer recurrence, and sentinel lymph nodes mapped to internal mammary area (but were not biopsied), do you offer post-mastectomy radiation to cover the IMNs?

If no enlarged lymph nodes on imaging, and no other high risk features. Would your opinion change if the patient has had prior breast radiation?

Answer from: Radiation Oncologist at Community Practice

I would favor including as there is possibility of microscopic disease based on T stage and phenotype.