cT1N0 breast cancer. RNI?

65 yo cT1N0 ER/PR- HER2+ with NA taxol/herceptin. s/p lumpectomy and SLNB, ypT1N1 with 4 mm focus of residual disease in the node. Had she been cT1N1 and ypT1N1 I'd do RNI. Had she been cT1N0 and pT1N1, I'd probably just do WBRT. Wondering if there's a way to not do RNI here.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Radiation Oncology Source Type: forums

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This study describes rates and predictors of positive margins for invasive breast cancers in the National Cancer Database (NCDB).MATERIALS AND METHODS: From 2004 to 2013, patients with non-metastatic invasive breast cancers who underwent breast conservation surgery were identified from the NCDB. Patients' demographic, clinical, and facility of treatment characteristics were collected and compared. Per SSO-ASTRO-ASCO criteria, margin negative is defined as no gross or microscopic disease (i.e. no tumor on ink). Bivariate tests and multivariate logistic regression were conducted to identify independent predictors of patients...
Source: Breast - Category: Cancer & Oncology Authors: Source Type: research
This study evaluates breast MRI response of ER/PR+ HER2- breast tumors to pre-operative SABR with pathologic response correlation.METHODS: Women enrolled in a phase 2 single institution trial of SABR for ER/PR+ HER2- breast cancer were retrospectively evaluated for radiologic-pathologic correlation of tumor response. These patients underwent baseline breast MRI, SABR (28.5 Gy in 3 fractions), follow-up MRI 5 to 6 weeks post-SABR, and lumpectomy. Tumor size and BI-RADS descriptors on pre and post-SABR breast MRIs were compared to determine correlation with surgical specimen % tumor cellularity (%TC). Reported MRI tumor dime...
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Source Type: research
Clin Imaging. 2021 Jun 26;80:11-15. doi: 10.1016/j.clinimag.2021.06.032. Online ahead of print.ABSTRACTOBJECTIVE: Although extensive analyses evaluating screening mammography for breast cancer have been published, some utilized databases do not distinguish between modes of detection, which confounds the conclusions made about the impact of screening mammography.METHODS: A retrospective cohort study of women at our institution with pathologically-proven breast cancer from January 2015 to April 2018 was conducted. Subjects were categorized by their mode of diagnosis: screening or non-screening. Patient demographics, tumor ch...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Source Type: research
Opinion StatementTreatment sequencing in early-stage breast cancer has significantly evolved in recent years, particularly in the triple negative (TNBC) and human epidermal growth factor receptor 2 (HER2)-positive subsets. Instead of surgery first followed by chemotherapy, several clinical trials showed benefits to administering systemic chemotherapy (and HER2-targeted therapies) prior to surgery. These benefits include more accurate prognostic estimates based on the extent of residual cancer that can also guide adjuvant treatment, and frequent tumor downstaging that can lead to smaller surgeries in patients with large tum...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionThe results of our study reflect that a selected group of HER2+ BC and TNBC with elevated TILs, L+R is associated with improvement of 5-year DFS and 5-year OS.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
CONCLUSIONS: A substantial minority of patients with cT1-3N1 HR+/HER2- disease with palpable adenopathy had two or fewer positive nodes on ALND. Standard clinicopathologic features and ultrasound findings can help identify candidates for upfront sentinel lymph node biopsy as a strategy to avoid ALND. Prospective studies evaluating this approach are warranted.PMID:33876360 | DOI:10.1245/s10434-021-09943-7
Source: Ann Oncol - Category: Cancer & Oncology Authors: Source Type: research
 Clinical information required for pathologic evaluationIt is important that the multidisciplinary team (e.g., surgeons, radiologists, and pathologists) communicate as a team for patient care; this is covered in detail in our companion multi-disciplinary paper.41 At a bare minimum, the request form must clearly indicate neoadjuvant systemic therapy has been given, along with the location and pretreatment size of the tumor(s). A suggested template requisition form that can be sent with the specimen is included belowSpecimen handlingPriorities for evaluation of the surgical specimen are different after neoadju...
Source: Oncopathology - Category: Cancer & Oncology Tags: breast Breast Biopsy Procedure breast cancer Source Type: blogs
CONCLUSION: Addition of T to RT did not achieve the objective of 36% reduction in IBTR rate but did achieve a modest but statistically nonsignificant reduction of 19%. Nonetheless, this trial had negative results. Further exploration of RT plus T is needed in HER2-positive DCIS before its routine delivery in patients with DCIS resected by lumpectomy.PMID:33739848 | DOI:10.1200/JCO.20.02824
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Source Type: research
Indian J Pathol Microbiol. 2021 Jan-Mar;64(1):161-164. doi: 10.4103/IJPM.IJPM_160_19.ABSTRACTA 60-year-old Chinese male with a hard mass, pressure pain, and ulcerous skin under his left axilla was first diagnosed with apocrine carcinoma, most likely metastasis from breast cancer. PET/CT scan detected multiple bone metastasis and enlarged lymph nodes at left axilla, mediastinal area 7, and left pulmonary hilus. Lumpectomy was performed to remove the mass followed by chemotherapy and radiotherapy against focal bone metastasis, left axillary lesion, and left subcutaneous chest wall. PET/CT examination showed progressive disea...
Source: Indian Journal of Pathology and Microbiology - Category: Pathology Authors: Source Type: research
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