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Topics: Breast Cancer • Radiation Oncology

Do you routinely offer PMRT for T3N0 breast cancer?   

Although these patients are included in the Danish trials, Taghian et al. & Floyd et al. both showed ~ 7% LRR in this group of patients without radiation. In a patient without high risk feature (no LVI, negative margins, post-menopausal) can PMRT be omitted?



Answer from: Radiation Oncologist at Academic Institution
Yes, especially in young women. The Danish PMRT trial included T3N0 patients, and in the pre-menopausal group, there was a meaningful increase in overall survival (10-year actuarial survival 82% vs 70%, with vs without PMRT; Overgaard et al., PMID 9395428). Now, one can argue that this is an old s...
Comments
Radiation Oncologist at Weill Cornell Medical College
Agree.
Radiation Oncologist at Missouri Cancer Associates
Dr. @Lawrence B. Marks, my patient is >60 with...
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Answer from: Radiation Oncologist at Community Practice
I do not routinely offer PMRT for T3N0. From the data published from NSABP and others, it seems to be that the biology of these tumors is different and the risk of local failure is rather low (around 7%). However, if I see risk factors like LVI, young age (may be <50), grade III, close margins, o...
Comments
Radiation Oncologist at University of Minnesota
I completely agree with your line of thinking. Wh...
Radiation Oncologist at Mass General Physicians Organization
Thank you for your comments. I remember the multiv...
Radiation Oncologist at Chesapeake Potomac Regional Cancer Center
Dear @Alphonse G. Taghian, would you consider PMRT...
Radiation Oncologist at Palo Alto Medical Foundation
Dear Dr Taghian, I have a grade 1 lobular carcinom...
Radiation Oncologist at Mass General Physicians Organization
Dear Kathleen and Dhara, The whole idea about the...
Radiation Oncologist at Chesapeake Potomac Regional Cancer Center
Thank you!
Radiation Oncologist at Palo Alto Medical Foundation
Great - very helpful, thank you!
Radiation Oncologist at CCare
Dr. @Alphonse G. Taghian, when you offer PMRT for ...
Radiation Oncologist at Mass General Physicians Organization
I think it is difficult to generalize a specific t...
Radiation Oncologist at UNC School of Medicine
I think that Local Failures are perhaps under-repo...
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Answer from: Radiation Oncologist at Academic Institution
There is hardly any prospective data focusing specifically on T3N0 postmastectomy and there has never been any data demonstrating a benefit of PMRT in this setting. Our group published a SEER study in 1,865 patients demonstrating no improvement in 10-yr cause specific survival with PMRT overall, and...
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