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Breast Cancer • Radiation Oncology
Would you offer PMRT to a patient with potential metastatic disease?
In a patient with an ER-positive, HER2-negative ILC with heavy nodal burden s/p mastectomy, CT shows multiple new sclerotic bone lesions, but FDG-PET and bone scan are negative.
Would you proceed with PMRT, or defer pending additional staging (e.g., ER-targeted PET), and how would you time PMRT relative to planned endocrine ± CDK4/6 therapy?
Answer from: Radiation Oncologist at Community Practice
If an additional ER scan is planned, I will wait to see the results. If there are unequivocal mets, I would not offer PMRT; otherwise, I would offer PMRT. If PMRT is offered, I will start endocrine therapy, but add the CDK4/6 inhibitor after RT is done.
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