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

Would you favor re-excision?

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

If the patient had prior ipsilateral breast cancer >20 yrs 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
Radiation Oncologist at University of Colorado School of Medicine
Agree; and if RT, boost to lumpectomy bed given +v...
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