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Would you consider radiation omission for a patient with a Stage I breast cancer with an elevated Oncotype Dx?   

The patient is an otherwise healthy patient in her 60s with an ER-positive, PR-positive, HER2 negative grade 3 pT1N0 invasive ductal carcinoma following lumpectomy with negative margins (>4 mm) and no evidence of lymphatic vascular invasion.

Oncotype Dx returned with a recurrence score of 28 such that the patient will receive chemotherapy. 

Would you consider radiation omission in this patient? If so, how would you justify your rationale as to why you would or would not offer RT? 



Answer from: Radiation Oncologist at Academic Institution
Comments
Radiation Oncologist at Willis-Knighton Medical Center
No, I would not consider omission in this patient ...
Radiation Oncologist at Prairie Lakes Healthcare System
Agree. I do not base my recommendation for breast ...
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Answer from: Radiation Oncologist at Community Practice
Comments
Radiation Oncologist at Confluence Health
I appreciate the time and the opinions presented. ...
Radiation Oncologist at Varian Medical Systems/Allegheny health network
In the NSABP 14 and 20 analysis of the risk of LRR...
Radiation Oncologist at Coastal Radiation Oncology
Agree with @Lane R. Rosen, @Simul Parikh, and @Bru...
Radiation Oncologist at Baylor Scott & White Health
Agree with @Ben Wilkinson: yes we were absolutely ...
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