You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is In carcinoma breast, adjuvant radiotherapy is indicated after modified radical mastectomy in all of the following except and explain in detail?
.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