Breast: Radiation Therapy (RT)

After Breast-Conserving Therapy (BCT)

• Whole-Breast Radiation Therapy Reduces the Locoregional Recurrence Rate & Risk of Breast Cancer Death
• Must First Have Negative Margins from Excision
• Requirements to Consider RT Omission:
  • Elderly (> 65-70 Years Old)
  • Stage I (T1, N0)
  • Hormone-Receptor Positive & Willing to Have Endocrine Therapy
• Regional Nodal RT
  • Consider for Positive Lymph Nodes if Axillary Lymph Node Dissection is Not Completed
  • Indications:
    • ≥ 3 Lymph Nodes Positive (May Still Consider for 1-2)
    • T3-T4 Primary Lesions
    • T2 Lesion with High-Risk Features

Post-Mastectomy Radiation Therapy (PMRT)

• Field: To Both Chest Wall & Regional Nodes (Unless Axillary Lymph Node Dissection Completed)
• Indications:
  • Positive Margins
  • T3 or T4 Tumor
  • Skin or Chest Wall Involvement
  • Advanced Nodal Disease (N2/3)

Relative Contraindications

• Previous Radiation Therapy
• Connective Tissue Disorders (Scleroderma, Sjogren Syndrome or Systemic Lupus Erythematosus)