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FRCR Part 2 > Breast > Flashcards

Breast Flashcards

1
Q

What is the a/b ratio of the breast

A

3 Gy

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2
Q

What are the indications for a boost?

A

<50 or high risk features
E.g. G3
TNBC
N1
Threatened or positive margin

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3
Q

What is the fractionation for whole breast RT post BCS?

A

26Gy in 5#

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4
Q

What is the increased risk of breast boost?

A

Double risk of moderate-severe fibrosis

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5
Q

What is the increased risk of breast boost?

A

Double risk of moderate-severe fibrosis

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6
Q

In what women can post-BCS RT consider being omitted?

A

> 70
G1-2
T1N0 (<2cm)
ER+ HER2-
Having 5 years ET with mammograms to 10 years

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7
Q

What is the fractionation for chest wall RT?

A

26Gy in 5#

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8
Q

What is the fractionation for axillary nodal RT?

A

40Gy in 15#

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9
Q

Assuming an a/b of 3Gy, what is the BED of 26Gy in 5# compared with 40Gy in 15#

A

40Gy in 15# = 66.7Gy
26Gy in 5# = 60Gy

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10
Q

What are the indications for IMC RT?

A
  • T4 and/or N2/3 disease
  • 1-3 macromets (N1) and medial disease
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11
Q

How should IMC RT be delivered

A

Breath hold

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12
Q

What are the constraints for heart, ipailateral lung, contralateral breast?

A

Heart V17Gy <10%
Ipsi lung V17Gy <35%
Mean contralateral breast <3.5Gy

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13
Q

In patients who have not received NACT, how should isolated tumour cells and/or micromets only on SLNB be managed?

A

No axillary treatment needed for micromets only

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14
Q

How should the axillary be managed in patients who have undergone NACT and were thought to be N0 to start with but are found to have fibrosis in 1/3 LN?

A

No axillary treatment needed (as only 1 with evidence of downstaging in a sample of at least 2 SLNs)

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15
Q

How should the axillary be managed in patients who have undergone NACT and were thought to be N0 to start with but are found to have fibrosis in 1/2 LN?

A

No axillary treatment needed

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16
Q

How should the axillary be managed in patients who have undergone NACT and were thought to be N0 to start with but are found to have fibrosis in 1/1 LN?

A

Axillary RT

17
Q

How should the axillary be managed in patients who have undergone NACT and were thought to be N0 to start with but are found to have fibrosis in 2/3 LN?

A

Axillary RT

18
Q

What RT should be offered if 4/12 LN in ANC?

A

Treat levels 3-4 with RT if at least 4 nodes in clearance are positive

19
Q

How should axilla be managed in patients who start clinically N0 and become N1 on SLNB after NACT?

A

ANC

20
Q

How should the axilla be managed for patients who start clinically cN1 and become ypN0 after NACT?

A

Axillary RT (no need for clearance)

21
Q

How should the axilla be managed for patients who start clinically cN+ and become ypN1 after NACT?

A

ANC and RT to above axilla +- IMC

FRCR Part 2 (1 decks)

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