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Breast Cancer • Radiation Oncology
Would you consider omitting PMRT in cT3N0 triple negative breast cancer with a pCR?
In a young patient <30 years old with large pre-chemotherapy, multifocal disease with pCR following mastectomy, would you consider extrapolating the results of NSABP-51 and omitting PMRT?
Why or why not?
Answer from: Radiation Oncologist at Academic Institution
These are challenging cases with limited data as Dr. @Recht notes. In a young patient with cT3N0 disease with a pCR, I would discuss the lack of data and that RT may reduce rates of LRR with unclear survival benefits. I would discuss the pros and cons but I would be comfortable offering therapy give...
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Answer from: Radiation Oncologist at Academic Institution
There is a paucity of information on the risk of local-regional recurrence following mastectomy in patients following neoadjuvant chemotherapy (NACT). This is particularly so for those who present with clinical T3N0 cancers. The largest such cohort is from the NSABP B-18 and B-27 trials, performed f...
Answer from: Radiation Oncologist at Community Practice
My default was PMRT for T3N0 TNBC with pCR as data available was limited. Now with B51 showing no benefit with about 20% being T3N1 questions routine use of PMRT. Any benefit had to be weighed against the downside especially if reconstruction was also done.