Do you offer APBI for patients with invasive disease if there is high grade DCIS present in the lumpectomy specimen?

In these situations, I am still comfortable offering PBI to patients. DCIS is seen with invasive disease in a fair number of cases so this comes up frequently and as long as other criteria are met, I view this as appropriate for PBI.

Studies of PBI have given doses that appear to be biologically equivalent to that given by WBI regimens without a boost. However, this may not be sufficient to treat certain patients. The BIG 3–07/TROG 07.01 trial randomly allocated 1,608 patients with “non-low risk” DCIS with uninvolved margins of ...

It depends on the extent of the high grade in situ component. I would not recommend partial breast irradiation if it was a T1mic, or if EIC was reported.

For invasive breast cancer, the presence of accompanying DCIS grade and extent can substantially influence local recurrence risk. In the most extre...