In cT4aN0 triple negative breast cancer would you still recommend PMRT if pCR, ypT0N0(sn), after neoadj chemo is achieved?

This case includes several distinct issues. The first is the accuracy of the initial staging. The AJCC 8th edition definition of clinical stage T4a is: "T4a is extension to the chest wall. Adherence/invasion to the pectoralis muscle is NOT extension to the chest wall and is not categorized as T4." E...

In addition to Dr. @Dr. First Last's extremely detailed and comprehensive answer, it is worth reminding ourselves that B-51 enrolled patients with cT1-3 N1 breast cancer and specifically excluded T4, so B-51 cannot be applied to the stated case. As Dr. Recht wrote, "All patients with locally advance...

Yes, I would recommend adjuvant radiation therapy.