Would you consider RNI in a patient with axillary recurrence after lumpectomy, whole breast RT and cavity boost 10 years ago?

The patient is now s/p neoadjuvant chemotherapy, mastectomy, and ALND for their ipsilateral recurrence, and pathology showing residual disease (ypT0N2).

Would you offer axillary RT in this scenario? Why or why not?

Answer from: Radiation Oncologist at Academic Institution

This patient has residual nodal disease after neoadjuvant chemotherapy and has a high risk of recurrence. I have typically treated the supraclavicular fossa and at risk axilla using a VMAT technique to limit skin dose in the area of overlap. You have 10 years of repair and the patient should tolerat...

Comments

Radiation Oncologist at University of Miami/Jackson Memorial Medical Center
Thanks @Janice, would you consider re-irradiation ...

Radiation Oncologist at University Hospitals Seidman Cancer Center
It would depend on her clinical T stage, but likel...

Answer from: Radiation Oncologist at Community Practice

Axillary nodal disease correlates most with chest wall recurrence (60-75% of post mastectomy recurrences are along the chest wall). After a disruption (like multiple surgeries), we don’t exactly know what the recurrence pattern will be, but it is highly unlikely to change to where CW would be ...

Comments

Radiation Oncologist at University of Miami/Jackson Memorial Medical Center
What dose and fractionation would you consider?

Please select the option that best describes you:

Would you consider RNI in a patient with axillary recurrence after lumpectomy, whole breast RT and cavity boost 10 years ago?

Related Questions