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Breast Cancer • Radiation Oncology
Would you offer partial breast irradiation for women with G2 4cm DCIS with close margins of 1mm but a very large breast size?
Why do the available guidelines restrict APBI to patients with lesion size <3cm? Is this purely from higher rates of necrosis noted in older brachytherapy series that allowed lesions up to 4-5cm? Or a reflection of risks of recurrence increasing with increasing lesion size?
Answer from: Radiation Oncologist at Community Practice
Although size cut off is arbitrary, DCIS tumor size is one of the risk factors for IBTR. For large-volume DCIS like this case in question, what is not known is if a 1 to 1.5 cm CTV margin would capture all microscopic areas of disease or do we need to treat larger volumes. For that reason, I favor I...
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