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Breast Cancer • Radiation Oncology
Do you offer APBI for patients with invasive disease if there is high grade DCIS present in the lumpectomy specimen?
If a patient has a small luminal A invasive tumor resected to negative margins with admixed high-grade DCIS, does the high-grade DCIS component influence you to treat with whole breast radiation plus or minus a boost instead of APBI?
Answer from: Radiation Oncologist at Academic Institution
In these situations, I am still comfortable offering PBI to patients. DCIS is seen with invasive disease in a fair number of cases so this comes up frequently and as long as other criteria are met, I view this as appropriate for PBI.
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Answer from: Radiation Oncologist at Academic Institution
Studies of PBI have given doses that appear to be biologically equivalent to that given by WBI regimens without a boost. However, this may not be sufficient to treat certain patients. The BIG 3–07/TROG 07.01 trial randomly allocated 1,608 patients with “non-low risk” DCIS with unin...
Comments
Radiation Oncologist at Cleveland Clinic
I agree re: boost, it is important to note that 30...
I agree re: boost, it is important to note that 30...
Radiation Oncologist at Beth Israel Deaconess Medical Center
Agree!
Agree!
Radiation Oncologist at Cleveland Clinic
Definitely a consideration. That being said, with ...
Definitely a consideration. That being said, with ...
Answer from: Radiation Oncologist at Community Practice
It depends on the extent of the high grade in situ component. I would not recommend partial breast irradiation if it was a T1mic, or if EIC was reported.For invasive breast cancer, the presence of accompanying DCIS grade and extent can substantially influence local recurrence risk. In the most extre...
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Radiation Oncologist at Associated Medical Professionals
A great question that I think points at some knowl...
A great question that I think points at some knowl...