Salvage Adaptive Radiotherapy for Locally Advanced Breast Cancer with Axillary Lymph Node Involvement after Failure of Neoadjuvant Chemotherapy

Abstract

Introduction. Neoadjuvant chemotherapy (NAC) is the standard treatment for locally advanced triple-negative breast cancer (TNBC), but when ineffective, surgical resection becomes difficult.

Case description. A 53-year-old woman was referred after failure of NAC for locally advanced TNBC on the right side with axillary lymph node involvement. After second-line NAC, the breast cancer was unresectable and high-dose adaptive radiotherapy was performed. The initial plan was to treat both the breast cancer and the axillary lymph node metastasis with rotational intensity-modulated radiation therapy (IMRT) with simultaneously integrated boost (IMRT-SIB). After the initial plan was completed, an adaptive plan was created to treat the remaining breast cancer and axillary lymph nodes. One year after radiotherapy, both the breast cancer and the axillary lymph node metastases disappeared with no serious adverse events.

Conclusion. High-dose adaptive rotational IMRT-SIB may be an effective salvage treatment for locally advanced TNBC after failure of NAC.