Would you consider radiation omission for a patient with a Stage I breast cancer with an elevated Oncotype Dx?
The patient is an otherwise healthy patient in her 60s with an ER-positive, PR-positive, HER2 negative grade 3 pT1N0 invasive ductal carcinoma following lumpectomy with negative margins (>4 mm) and no evidence of lymphatic vascular invasion.
Oncotype Dx returned with a recurrence score of 28 such that the patient will receive chemotherapy.
Would you consider radiation omission in this patient? If so, how would you justify your rationale as to why you would or would not offer RT?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Rutgers Robert Wood Johnson Medical School
Answered on
I would offer the patient treatment based on the fact that she is in her 60s with a presumably long life expectancy, a high grade lesion, and radiation will lower her risk of local recurrence significantly. Even with a lower Oncotype, radiation will lower the risk of recurrence significantly accordi...
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Mednet Member
Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on · Updated on
If a patient can get a screening mammogram, a diagnostic mammogram, a wire/seed guided localization, a segmental mastectomy +/- SLN bx, consideration of chemotherapy, consideration of 5+ years of ET, why would a 5-day course of whole breast RT/APBI that reduces recurrence by 60-80+% depending on the...
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