Would you offer PMRT to a pre-menopausal patient with early stage breast cancer, favorable biology, and an axillary dissection showing pN1a disease?

The role of PMRT in this situation remains controversial with factors considered including age/menopausal status, number of nodes, presence of ECE, receptor status, neoadjuvant chemo use, etc.

If the patient received neoadjuvant therapy and ypN1, I would offer PMRT.

If no neoadjuvant therapy, I often discuss older trials, then MA.20 and the pros and cons of RT. I discuss ongoing studies (ex. SUPREMO) where we don't have long-term data yet. I will also show them the nomogram we use (https://riskcal...

I usually favor no RT unless adverse anatomical factors.