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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, would a pCR in the breast and axilla change your approach to RT (boost, lymph node coverage, fractionation, etc.)? Why or why not?
Answer from: Radiation Oncologist at Academic Institution
The local-regional failure rate is quite low for patients with Clinical Stage II disease who have either a pathologic complete response (pCR) or negative axillary nodes (ypN0) with residual disease in the breast after neoadjuvant chemotherapy (NACT). The best known of these is the report of the NSAB...
Comments
Radiation Oncologist at UNC School of Medicine
@Abe: Masterful summary as always. I always learn ...
@Abe: Masterful summary as always. I always learn ...
Radiation Oncologist
Consider a dose reduction of ten percent over what you would have recommended in the absence of a complete response to both areas of disease and areas receiving elective treatment.
Excellent answer. Makes me re-evaluate my heuristi...
Thank you for the answer @Larry. Wonder if you'd e...
I do think that a node positive patient who has NA...
My practice is to offer adjuvant radiotherapy as w...
Outside a clinical trial, I do make decisions abou...
In response to @Todd's comment: When the systemic ...