Breast Cancer, Non-metastatic&nbsp;&nbsp;&nbsp;

Would you consider omission of radiotherapy in patients 70 years and older with invasive ductal carcinoma who had initially positive lumpectomy margins, but had no residual disease upon re-excision?

How do you respond to a patient who asks "Why do I still need breast radiation after chemotherapy if chemotherapy treats the whole body?"

This patient had a T1N0, ER/PR negative, HER2 negative breast cancer

6 Answers available

How would you manage a premenopausal patient with HER-2 positive DCIS in the setting of a prior HER-2 positive contralateral breast cancer?

The patient had a prior right-sided ER+ HER2-ve breast cancer, treated with neoadjuvant chemotherapy, MRM with ALND, and PMRT They recently developed...

What is your treatment approach in patients with early breast cancer with axillary soft tissue involvement, with or without concurrent lymph node involvement?

How would you approach a cT4 cN2 (22 cm in size) TNBC that shrank to 9 cm with KN-522 regimen but remains inoperable at the end of treatment?

Both sets of CT scans pre and post- chemoimmunotherapy show no evidence of distant mets.

What are your top takeaways from SABCS 2023?

For which patients, if any, do you typically order additional imaging workup for staging in early-stage breast cancer?

Can you safely proceed with breast irradiation during treatment with immunotherapy?

For a node positive, triple negative patient that underwent neoadjuvant chemotherapy followed by breast conservation with a complete pathologic respon...

In a patient with local recurrence of breast cancer after mastectomy, how would you sequence adjuvant treatment after wide local resection?

Assuming the patient had no prior radiation and has no evidence of metastatic disease, would you start with adjuvant radiotherapy or adjuvant systemic...

What are your top takeaways in Breast Cancer from ASCO 2023?

How do you approach the discussion with a patient who is seeking proton therapy for early stage breast cancer?

What is your approach to try to persuade her that photons would be a better option?

6 Answers available

In which situations do you consider post-mastectomy radiation therapy when the patient has a localized node-positive breast cancer with a complete nodal response and minimal residual disease in the breast post-neoadjuvant chemotherapy?

How does the potential for a patient to accept or forego adjuvant tamoxifen factor into your recommendations on adjuvant RT for DCIS?

Are there specific patient populations in which you may feel comfortable with a patient selecting only one adjuvant therapy approach (tamoxifen vs RT)...

What are the current timing recommendations for initiating radiation after lumpectomy?

The prior recommendations were between 6-12 months, but also were based on chemotherapy after surgery.

Does a pathologic complete response in the breast and axilla change your radiation recommendations?

In a woman with high-grade, clinically node positive invasive ductal carcinoma who receives neoadjuvant chemotherapy and breast conserving surgery, wo...

Would you treat a Stage I ER/PR positive HER2 negative breast cancer differently if it is associated with Lynch syndrome?

How are you using predictive tests such as DCISionRT (PreludeDx) or OncotypeDX DCIS in the management of DCIS?

What advantages/disadvantages are there between assays or over traditional clinical pathologic factors? What other concerns do you have?For additional...

Are there any contraindications to BCS and adjuvant radiotherapy in patients with BARD1 mutation?

What are your top takeaways in Breast Cancer from ASCO 2022?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

12 Answers available

What is the appropriate timeline to start post mastectomy chest wall/regional nodal XRT (+/- reconstruction) after surgery?

What if Medical Oncology wants to give more systemic therapy and further delay XRT start date?What should we be telling the Breast/Plastic surgeon/Med...

Would you offer PMRT to a perimenopausal female with a single positive LN with microscopic ENE who has otherwise low risk features?

How do you approach the decision to boost patients diagnosed with DCIS?

What factors do you consider?Is your thought process at all different from your approach to boost with IDC? Do you apply TROG 7.01 data (age <...

What resection margins are required for DCIS with a component of invasive disease?

What resection margins are required for pure DCIS with adjuvant RT? What resection margins are required for pure DCIS without RT? For additi...

5 Answers available

For a patient with breast cancer s/p lumpectomy found to have a heterozygous RAD50 mutation, is adjuvant radiation appropriate therapy or would you recommend completion mastectomy?

What additional benefit does radiation offer for a patient <65 years old with T1aN0 ER+ invasive carcinoma (tubular histology) of the breast?

Should we be performing sentinel lymph node biopsies for HR+ patients ≥70 years of age?

In light of updated monarchE trial data, it seems a SLNB would help delineate adjuvant treatment options in this population. However, Choosing Wisely ...

Are CHEK2 mutations a contraindication for breast conservation therapy with lumpectomy + RT?

Should patients with moderate penetrance pathogenic variants be managed similar to BRCA patients and consider risk reducing contralateral mastectomy?&...

What is your approach to the management of hot flashes in a patient who wants to use herbal medicine?

Do you allow patients with breast cancer on tamoxifen to use black cohosh?