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Breast Cancer • Radiation Oncology
In which patients do you omit a boost following whole breast irradiation?
Do patients > 60 years old with no high risk features have any significant benefit? Has the recent update of the EORTC boost trial affected your practice?
Answer from: Radiation Oncologist at Academic Institution
In a woman over 60 with a T1 or T2, low to intermediate grade tumor resected with clean margins (preferably greater than or equal to 2 mm), I think it is very reasonable to omit a boost. I tend to take these on a case by case basis. If I can deliver a boost with a small field (for example 8 cm or le...
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Answer from: Radiation Oncologist at Academic Institution
I think the 2018 ASTRO Whole Breast RT Guideline did a great job in suggesting when to omit a boost. I'd like to point to a couple of modern trials aside from the boost trials that have helped to guide my boost decision-making (and were surely in the minds of the authors of these statements).1) RTOG...
Answer from: Radiation Oncologist at Academic Institution
According to the recent 2018 ASTRO whole breast guideline published in PRO, the boost may be omitted in patients with invasive cancer over age 70 ER/PR+ of low or intermediate grade with widely >2 mm negative margins. Also for DCIS, age > 50 of low to intermediate grade with negative > 3mm ...