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In cT4aN0 triple negative breast cancer would you still recommend PMRT if pCR, ypT0N0(sn), after neoadj chemo is achieved?
Would prior RT (>30 years ago in this case) to the breast or ATM mutation alter your recommendations?
Answer from: Radiation Oncologist at Academic Institution
This case includes several distinct issues. The first is the accuracy of the initial staging. The AJCC 8th edition definition of clinical stage T4a is: "T4a is extension to the chest wall. Adherence/invasion to the pectoralis muscle is NOT extension to the chest wall and is not categorized as T4." E...
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Answer from: Radiation Oncologist at Academic Institution
In addition to Dr. @Recht's extremely detailed and comprehensive answer, it is worth reminding ourselves that B-51 enrolled patients with cT1-3 N1 breast cancer and specifically excluded T4, so B-51 cannot be applied to the stated case. As Dr. Recht wrote, "All patients with locally advanced breast ...
Answer from: Medical Oncologist at Community Practice
Yes, I would recommend adjuvant radiation therapy.