Would you offer radiation to an elderly patient with DCIS who would otherwise not meet criteria for RTOG 9804?
E.g. someone with high grade and/or >2.5cm disease? If we use age as a cutoff in invasive disease to omit adjuvant radiation based on the CALGB and PRIME II studies which showed no mortality benefit to adjuvant radiation, then can we do the same for all DCIS patients regardless of pathologic characteristics since there is no mortality benefit to adjuvant radiation in any DCIS patients?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Washington University School of Medicine in St. Louis
Answered on
I counsel elderly patients with DCIS about the risks and benefits of receiving radiation therapy. I offer radiation in patients with excellent performance status who are uncomfortable with the 1-2%/year recurrence risk with omission of radiation (extrapolating from RTOG 9804 as well as ECOG (Solin e...
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Mednet Member
Radiation Oncology · Rush University Medical Center
Answered on
Another comment: #1: What's the definition of elderly here? #2 What comorbidities are there? The death rate related to breast cancer is very low, even for larger, high grade DCIS. If a patient does not wish radiation therapy, I would be sure about margins. If there is any question, I would consider ...
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