Radiotherapy after mastectomy would not be required in which of the following case scenarios of breast ca:

Ans is 'b' i.e. Metastasis "Radiotherapy to the chest wall after mastectomy is indicated in selected patients in whom the risks of local recurrence are high. This includes patients with large tumours and those with large numbers of positive nodes or extensive lymphovascular invasion." - Bailey and Love For distant metastases or stage IV disease mainly palliative treatment is done to prolong survival and enhance the quality of life. Radiotherapy is usually not required. Management may include: Hormonal therapies that are associated with minimal toxicity are preferred to cytotoxic chemotherapy. Appropriate candidates for initial hormonal therapy include women with hormone receptor-positive cancers; women with bone or soft tissue metastases only; and women with limited and asymptomatic visceral metastases. Systemic chemotherapy is, indicated for women with hormone receptor-negative cancers, symptomatic visceral metastases, and hormone-refractory metastases. Bisphosphonates, which may be given in addition to chemotherapy or hormone therapy, should be considered in women with bone metastases.