How would you approach the treatment of an elderly patient with dementia, with multifocal pT1b IDC s/p lumpectomy, with extensive DCIS, and medial margin positive for DCIS?

Topics: Breast Cancer • Radiation Oncology • Geriatrics Oncology

Would you favor re-excision? If re-excision and surgery are not an option, would you proceed with radiation or observation?

If the patient had prior ipsilateral breast cancer >20 years ago treated with lumpectomy and RT, what dose and fractionation scheme would you use for reirradiation, especially considering the patient's dementia?

Answer from: Radiation Oncologist at Community Practice

It would be a function of her expected survival from dementia (geriatric assessment) and will her breast cancer be an issue in her lifetime based on the assessment. Based on that option, could be nothing to AI or RT.

Comments

Radiation Oncologist at University of Colorado School of Medicine
Agree. If RT, boost to lumpectomy bed given that +...

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