A 59 years old patient chooses 2 separate lumpectomies for synchronous stage I breast cancers in the same breast. It is done to preserve the breast and the patient's self-image. Lumpectomies are 4-6 cm apart roughly, different quadrants. Both are luminal A cancers. Whole breast radiation is needed. Would you boost after 42.6/16 fractions?
Breast boost in multicentric disease
- Thread starter seper
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In most cases I would boost. I might consider omitting the boost if low grade.
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I typically don't boost a 60 year old luminal A with margins > ~2mm if doing whole breast (often would give partial breast XRT to these patients anyway, but not all of them). Obviously wouldn't recommend partial breast for this case.
Not always, but I do most often talk to patients about role of a boost and my opinion regarding this (ie push hard for triple negative, close margins, etc. Offer but don't push for favorable cases, etc). If it's a borderline case I specifically go over pro's/con's of boost. May want to discuss this with your patient.
Obviously, cosmesis is important to this patient, so I would favor no boost and do exactly what you mentioned - 42.6 Gy /16.
Not always, but I do most often talk to patients about role of a boost and my opinion regarding this (ie push hard for triple negative, close margins, etc. Offer but don't push for favorable cases, etc). If it's a borderline case I specifically go over pro's/con's of boost. May want to discuss this with your patient.
Obviously, cosmesis is important to this patient, so I would favor no boost and do exactly what you mentioned - 42.6 Gy /16.
