Would you treat regional lymph nodes in an elderly patient with a triple negative pT2 IDC of the UOQ of the left breast s/p lumpectomy with N0 sentinel node biopsy, but was clinically node negative?

The tumor was 3.2 cm; post-op margins were negative, but <0.1 mm. The patient has excellent performance status. She will not be receiving systemic therapy.

Would you treat just the whole breast, high tangents, or RNI?

Would you use hypofractionation if treating the regional nodes in addition to the breast?

Answer from: Radiation Oncologist at Academic Institution

What was the reason SLNB was omitted? While pathological nodal assessment is sometimes omitted, that most commonly applies to patients who are older (age >70) with small (T1) tumors that are ER positive, paralleling the inclusion criteria of CALGB 9343 in which 2/3 of patients did not have pathol...

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Radiation Oncologist at St. Joseph's Health/RCCA
Thank you so much for your detailed response! The...

Radiation Oncologist at David Geffen School of Medicine at UCLA
Thank you for providing the additional information...

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Would you treat regional lymph nodes in an elderly patient with a triple negative pT2 IDC of the UOQ of the left breast s/p lumpectomy with N0 sentinel node biopsy, but was clinically node negative?

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