How do you treat a patient with early-stage breast cancer s/p lumpectomy and oncoplastic reconstruction with a positive margin, when re-excision is not feasible?  

It depends on the level of oncoplastic surgery done. If level 1, we can identify the surgical site and can boost after whole-breast RT of 26 in 5 or 40 in 15. If level 2 or 3, then just increase the whole breast dose to 42.5 in 16, as we can’t identify the boost area.Han et al., PMID 40024440