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Breast Cancer • Radiation Oncology
How would you approach radiation for an elderly patient with pT2N1 TNBC s/p MRM and ALND who refused chemo-immunotherapy?
The patient is an elderly female with a good KPS who presented with a cT2N1 triple-negative breast cancer.
The patient refused chemotherapy and immunotherapy (both pre and post surgery) and is now status post mastectomy and ALND (1/12 LN positive, 2 cm, no ECE), found to have pT2N1 disease (4 cm tumor, +LVSI, Grade 3) with widely negative surgical margins?
Would you offer PMRT in this case? Why or why not?
Answer from: Radiation Oncologist at Community Practice
RT will offer improved local control in this patient, as she has an elevated risk of LRR (positive LN, triple negative, large-ish T2, grade 3, LVSI).
It will be unlikely to change her survival, as the data for PMRT did not show survival benefit until the chemotherapy was good enough to decrea...
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