Does a pathologic complete response in the breast and axilla change your radiation recommendations?

No. While it is tempting to assume that the chemotherapy has taken care of the local regional disease if there was a pathologic complete response (pCR), we do not yet have good assurance that this is the case. There is an ongoing randomized study testing this hypothesis in patients who have positive...

The local-regional failure rate is quite low for patients with Clinical Stage II disease who have either a pathologic complete response (pCR) or negative axillary nodes (ypN0) with residual disease in the breast after neoadjuvant chemotherapy (NACT). The best known of these is the report of the NSAB...

Consider a dose reduction of ten percent over what you would have recommended in the absence of a complete response to both areas of disease and areas receiving elective treatment.