In a locoregionally advanced breast cancer with multiple positive surgical margins, how safe is it to wait for a re-excision vs treating upfront with comprehensive RT if surgery cannot be done the short term due to the COVID outbreak?
Radiation in the setting of positive margins is sub-optimal and from my understanding high boost doses do not replace further surgery. Is it better to wait some time until re-excision done or to treat comprehensively and leave surgery for salvage with the understanding of providing sub-optimal control outcomes?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Allegheny Health Network, Pittsburgh
Answered on
Agreed, higher radiation dose will not replace negative margins. Obtaining negative margins is ideal. If the patient is a systemic therapy candidate, I would agree with @Dr. First Last and proceed with systemic therapy and then re-excision.
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
At our institution, we let the patient continue systemic treatment (AI or chemo based on phenotype) with plan for re-excision once COVID-19 settles down and then RT.
Join for free or sign in to see the full answer