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Breast Cancer • Radiation Oncology
Would you offer PMRT to a patient with pTisN1a left breast DCIS?
The patient had an ER-PR-HER2+ cancer, underwent SLNBx with 1 lymph node positive for macrometastasis, with a focus of DCIS that measured 11 cm
What if the patient was pT0N1a with 1 lymph node positive for macrometastasis?
Answer from: Radiation Oncologist at Community Practice
Macrometastases suggest there is missed invasive disease in the midst of 11-cm DCIS. For one macromet with only SLNB done, I would add CW and RNI as part of treatment, but if I had an ALND, then RT can be avoided.
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Answer from: Radiation Oncologist at Community Practice
I would treat this patient for at least two reasons. And this is largely because I conceptualize the goal of these cases not as prevention of isolated locoregional recurrence, but as reduction of the risk of breast cancer (and overall) mortality.
In this case, the definition has invasive cancer, gi...
Answer from: Radiation Oncologist at Academic Institution
I discussed the indications I use for recommending PMRT for patients having upfront surgery at length in commenting on the implications of the SUPREMO trial in this forum on December 8, 2025. As I noted in that post, multiple studies have demonstrated low risks of axillary failure following mastecto...