Breast is the worst: another case!
42 year old healthy female diagnosed with a huge DCIS , received mastectomy and sentinel lymph node dissection. Inside the 11cm big DCIS, 2 invasive ductal carcinomas were found, biggest one was 2.2cm in diameter. Axillary status is pN1 with a micrometastasis in 1 / 3 nodes (0.5 mm), no ECE. Reconstruction was performed with an implant. Oncotype Dx score is 12, so no chemotherapy. So, it's a pT2(m) pN1 (1/3mi) cM0 L0 V0 Pn0 R0 ER100% PR10% Her2- G2 invasive ductal carcinoma. Looking... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - June 30, 2021 Category: Universities & Medical Training Authors: Palex80 Tags: Radiation Oncology Source Type: forums

cT1N0 breast cancer. RNI?
65 yo cT1N0 ER/PR- HER2+ with NA taxol/herceptin. s/p lumpectomy and SLNB, ypT1N1 with 4 mm focus of residual disease in the node. Had she been cT1N1 and ypT1N1 I'd do RNI. Had she been cT1N0 and pT1N1, I'd probably just do WBRT. Wondering if there's a way to not do RNI here. (Source: Student Doctor Network)
Source: Student Doctor Network - December 28, 2020 Category: Universities & Medical Training Authors: Ray D. Ayshun Tags: Radiation Oncology Source Type: forums

Her2/Neu brain mets
I am trying to identify literature which reports the incidence of leptomeningeal dissemination (LM) in patients with resected HER2/neu amplified brain mets in the posterior fossa. Can anyone help point me in the right direction? (Source: Student Doctor Network)
Source: Student Doctor Network - March 2, 2020 Category: Universities & Medical Training Authors: Gfunk6 Tags: Radiation Oncology Source Type: forums

metastatic breast Ca that responded very well to CT.....
Dear Colleagues, What would you do in this case? 57 years old female with no comorbidities, that presented with a metastatic breast carcinoma. Locally, the tumor was very locally advanced ulcerating into the skin and invading the pectorals with high burden of disease in the axilla. Pet CT showed: positive nodes in the mediastinum, hilarious regions and many lung nodules. she is ER/PR+, Her2 negative, IDC. she received upfront chemotherapy with significant response: - significant... metastatic breast Ca that responded very well to CT..... (Source: Student Doctor Network)
Source: Student Doctor Network - September 3, 2019 Category: Universities & Medical Training Authors: Kroll2013 Tags: Radiation Oncology Source Type: forums

PMRT for this patient?
Dear colleagues, i need your opinion concerning this patient: 44 yo patient diagnosed of a bifocal mass of the right breast 5*2*3 cm , UOQ, cN0 , no suspiscious nodes on MRI biopsy showed a poorly differentiated IDC with extensive high grade DCIS, HR neg, Her2 positive she received neoadjuvant chemotherapy with complete response. pathology of the radical right mastectomy with sentinel node showed: no residual tumor, 0/1 LN, LVSI was not specified. do you give PMRT taking into... PMRT for this patient? (Source: Student Doctor Network)
Source: Student Doctor Network - May 30, 2019 Category: Universities & Medical Training Authors: Kroll2013 Tags: Radiation Oncology Source Type: forums