Are there situations in which you would definitely recommend radiation in an elderly patient with ER+, early stage breast cancer?   

I always have a little trepidation in answering questions whereby I would “definitely” recommend any therapeutic path as clinical decision making needs to be a bit more nuanced. Every situation requires a careful weighing of multiple inputs including clinical tria...

Dr Wazer has written a thoughtful scholarly answer to this question with which I agree, but I would emphasize his concluding sentences.  Too little attention has been paid to the issue of RT alone vs hormonal rx alone and the relative toxicities of each. Particularly with the use of AI's, compl...

I wholeheartedly agree with @David E. Wazer and @Leonard Prosnitz. Their answers do take us a few steps away from the original question to the larger issue of what if any adjuvant therapy is needed for women with small breast cancers.It is disappointing that the option of adjuvant radiation alo...

One additional factor is patient willingness to proceed with endocrine therapy and be compliant on treatment. Otherwise, I use high grade, nodal positivity, multicentricity

At I present would offer RT for high grade (based on prime2) or node positive disease (not included in prime or CALGB) 

15-20 year+ life expectancy.  The Calgb trial did in fact show a difference in IBTR rates, it's just that that difference was not felt to be clinically significant at 10 years of follow up. That rate of recurrence is a function of time and will increase with further follow up. If a 70-75 year...