When evaluating for PMRT in patients who did not receive neoadjuvant chemotherapy and are found to be pN0, do you utilize clinical T-staging, or pathologic T-staging?

If no neoadjuvant therapy, I rely on the pathologic staging rather than clinical staging for PMRT decisions.

So, for a cT3 that is a pT1-2, I would not offer PMRT. I do consider factors including receptor status, margins status, LVSI, and age.