8.1.4 Radiotherapy after Total Mastectomy on Early...
Early breast cancer can be performed with total mastectomy，and axillary treatment with axillary dissection and sentinel lymph node biopsy.Sentinel lymph node biopsy is indicated for patients with negative axillary lymph nodes.If the sentinel node is negative，no further axillary dissection is required；if the sentinel node is positive，further axillary dissection is required.However，if the lymph node metastasis lesions are small，it is still controversial whether it is necessary to clean.2016 American Society of Radiation Oncology guidelines：if doctors and patients choose not to have axillary dissection，regardless of the outcome of further axillary cleansing，there is enough information to support the patient's need for postoperative radiotherapy，you can choose radiotherapy；if not enough Information support patients need postoperative radiotherapy，and axillary cleansing is recommended.(https://www.daowen.com)
The chest wall and the upper and lower lymphatic drainage area of the clavicle are the most common recurrence sites in patients after total mastectomy.Radiotherapy is generally used to irradiate these two parts；whether the inner breast area needs to prevent radiation has been controversial.The preventive dose of the chest wall and regional lymph nodes was 45-50 Gy，1.8-2 Gy，once daily，5 weeks.There are no randomized clinical trials of large-segment radiotherapy after modified radical mastectomy for breast cancer.