In carcinoma breast, adjuvant radiotherapy is indicated after modified radical mastectomy in all of the following except
.Radiotherapy in carcinoma breast Indications: * Patient who undergo conservative breast surgery, breast is irradiated after surgery * After total mastectomy, external irradiation is given to axilla. * Patients with higher risk of local relapse after surgery: a. Invasive carcinoma. b. Extensive in situ carcinoma. c. Patients under 35 years. d. With multifocal disease. * In bone secondaries, to palliate pain and swelling. If there is pathological fracture in the bone, internal fixation has to be done along with external irradiation. * Inflammatory carcinoma of breast. * In atrophic scirrhous carcinoma of breast, as a curative radiotherapy. * As preoperative radiotherapy, to reduce the tumour size and downstage the tumour, so that the operability is better. * More than 4 positive lymph nodes in the axilla, pectoral fascia involvement, positive surgical margins, extranodal spread or in patients with axillary status not known/not assessed. ref:SRB&;s manual of surgery,ed 3,pg no 485
ER, PR hormone receptor negative tumour
Tumour size more than 5 cm
Positive margins
More than four positive axillary lymph nodes
Endocrinology and breast