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Expert Opinion / Cases · May 07, 2018

Management of Axilla in Clinically Stage I Breast Cancer With Node Positive Disease on SLN Biopsy

Written by
Sameer Nasir MD


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    Ca. left Breast, pT1b N1a The treatment Plan for such a patient in our department: Breast +Axillary RT., with or without SCF RT as given below Her age is >50, T1lesion, ER positive, G-1tumour. If there is no LVI, RT plan will be Whole breast Rt including level I & II axilla. Contour will be done for Level I & II axilla which will be included in the Breast field as modified tangents. Dose will be 42.7Gy/16Fr followed by supplement RT to breast tumour bed-10Gy/5Fr. RT will be delivered by deep inspiratory breath hold method, 4D-RT, to reduce the cardiac dose If LVI is present, then add additional field to cover axilla level-III with SCF to a dose 45Gy/20Fr Even if Oncotype DX score is low, the plan will be the same because of N1a status

  • Luca Licata

    Considering the low tumor burden (T1b and only one positive lymph node) and its biologic characteristics (G1, ER/PR +), I probably would not propose the use of post-mastectomy RT. I would prescribe only adjuvant endocrine therapy

  • Jan 20, 2021

    Pending Moderator approval.

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