Would you offer PMRT when the only indication is a focally positive margin?

If this is the only indication (T1-T2N0 and no other risk factors like LVSI, high-grade disease, triple negative, etc.), then would consider only if the patient was younger (<50 years old). It appears these patients have a much higher rate of recurrence than older patients and chest wall-only RT is a reasonable option to reduce the rate of recurrence. Unlike PMRT for higher-risk patients, this is unlikely to affect survival. The challenge here is that it is difficult to identify where the positi...