In what setting is PMRT indicated for T1-2N0 breast cancer?  

In general, I do not offer PMRT to node negative patients with the exception of broadly positive margins. However, there is data to support the use of CW and RNI in the recently published EORTC 22922 trial in which more than 40% of patients were node negative (25% of patients were mastectomy patient...

At present, outside the setting of a clinical trial, we only treat T1 and T2 disease with PMRT when the margin is positive, especially when it is associated with other adverse factors like LVSI, high grade, ER negative disease, and T2 size. There are retrospective studies supporting RT for T1/...

There was also an interesting RCT conducted in China (Wang et al, Radiatherapy Oncol 2011) where women with triple negative stage I-II were randomized to chemotherapy alone vs. chemotherapy + RT after mastectomy. Interestingly, they found improvement in RFS and OS rates. More than 80% of patients in...

NCCN allows for the "consideration" of PMRT in T1/2N0 patients if margins <1 mm, but technically negative.  I have treated such women if they have other risk factors such as; age <50, LVSI, >2 cm, triple negative, or Grade 3. Retrospective data suggest that in such women the risk of L...