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Breast Cancer • Radiation Oncology
What RT fields should be used to treat a triple negative breast cancer with biopsy positive lymph nodes and a pCR to neoadjuvant chemotherapy?
If there is a pCR in the breast and nodes do you treat the breast/chest wall SCV and full axilla? IMNs? Would the type of surgery (lumpectomy vs mastectomy) have an impact on your nodal fields? If the patient only has a sentinel node biopsy would that change the fields you treat? What about if the patient was ER/PR+ or Her2 +?
Answer from: Radiation Oncologist at Academic Institution
Practice patterns after NAC remain highly variable with no clear accepted standard particularly when there is a complete pathologic response (See Haffty et al. Red Journal 2016). While B51 may answer this question the jury will be out for a long time. Clearly enrollment in B51 is the ideal approach....
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Answer from: Radiation Oncologist at Academic Institution
I like Dr Haffty's answer from 3 years ago. It should be emphasized that the experimental arm in B51 is omitting RT from pts who have had path CR with neoadjuvant chemo, that comprehensive breast or chest wall RT plus nodal RT is standard of care for node positive patients in most circumstance...
Answer from: Radiation Oncologist at Community Practice
Currently the answer to this question is not known and is part of ongoing NSABP 51 study. Practice patterns vary a lot and there is no consensus, some institutinos treating all fields for all subtypes and others treating selectively. We, in general, for T1 or early T2 disease who are nod...
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Radiation Oncologist at Varian Medical Systems/Allegheny health network
The above argument applies for N1 disease only. As...
The above argument applies for N1 disease only. As...