3DCRT Vs IMRT after Mastectomy

[Meghanat]

Hello,

My Mother was diagnosed with Stage 3C breast cancer in Sept 2018. She completed neoadjuvant chemotherapy (3FAC + 12 Weekly Nab-Paclitaxel). She is ER+ve (80%) PR +ve (20%) Her2 -Ve. She achieved PCR after Neoadjuvant Chemo.

We met radiation oncologist today and doctor said they will not be able to cover internal mammary nodes without Significant Co-morbidities. He also says IMRT is not recommended for Mastectomy cases as it would result in esophagitis.

The first PET CT indicated positive internal mammary node. I am not sure what the benefit of RT without covering Internal mammary nodes despite knowing that it was positive in first PET CT. Also, I read IMRT is more safer than 3DCRT in higher doses, but doctor said completely other way around and the justification was that IMRT is not recommended for MRM cases. Can you please let me know about this

[Ambie]

Hello Meghanat. I am really sorry to hear about your mother. I know it's a very scary time for her and her family. I was diagnosed in May 2018 and had to undergo mastectomy, chemotherapy and radiotherapy. The radiotherapy done was 3DCRT. I don't have any idea about why I was given 3DCRT and not IMRT, but I can tell you that apart from the radiation burn on my neck I did not have any side effects. Please have faith in your doctor. I would leave the technical discussion to the doctors on the forum.