CVD and APBI

[Reaganite]

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Have a patient with RA who really, really wants APBI. Would you do it?

Literature seems to suggest that RA is the "safest" CVD to radiate, and I've even seen a few series on whole breast RT in RA patients. Also, looking through exclusion criteria from RTOG 0413, RA isn't even included. But there is a paucity of data on APBI in this setting. Other than this, can't find anything on APBI: http://www.brachyjournal.com/article/S1538-4721(10)00250-3/abstract

 

[medgator]

RA and lupus are the AI disorders I don't worry as much about. Now, scleroderma on the other hand....

 

[Neuronix]

I wouldn't flinch. I would consent the patient that it is possible they could have a worse outcome vis a vis fibrosis and cosmesis vs conventional fractionation, but I do that for all partial breasts anyway.

I would only worry about scleroderma or active lupus on the skin in that area.

 

[seper]

I'd be worried about doing balloon-based barchy for a CTD patient in whom skin distance is marginal.