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Topics:
Breast Cancer • Radiation Oncology
Would you consider eliminating PMRT to the chest wall in select cases of T3N0 breast cancer?
Would you consider eliminating radiation to the chest wall in a patient greater than 50 years of age with a T3N0M0 grade 2, ER+/PR+ Her2 negative invasive ductal carcinoma s/p MRM with negative margins and no adverse features?
Answer from: Radiation Oncologist at Academic Institution
There are a number of studies, including the one below, that suggest that favorable ER/PR+, Her2 negative patients with T3N0 have low local recurrence rates without PMRT. Every case is individualized and should take into consideration all factors including size, margins, and other adverse features b...
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Answer from: Radiation Oncologist at Community Practice
Also agree with @Bruce. The largest series of T3N0 treated by mastectomy and no PMRT came from NSABP (Taghian et al., PMID 16921044.) showing that without radiation, LRF was <7%. This was a compilation of 5 large randomized studies investigating various chemotherapy regimens. This was also before...
Comments
Radiation Oncologist at Cancer Care of Western New York
If one decides based on large size with no other a...
If one decides based on large size with no other a...
Radiation Oncologist at Mass General Physicians Organization
If only size with no other high risk factors, I wo...
If only size with no other high risk factors, I wo...
Answer from: Radiation Oncologist at Academic Institution
I agree with Dr. @Haffty and would also add that such patients may be candidates for the MA39, TAILOR RT trial if Oncotype score is <26.
Answer from: Radiation Oncologist at Community Practice
We offer for a very select subset with LVI, triple negative, high Oncotype, or close margin.