Thanks! Just curious- in your textual example of a low risk pT2N1 patient you state PMRT is likely minimally beneficial (I agree, see eg SUPREMO). Yet your flowchart algorithm treats these patients always? You’d just do CW alone if deescalating?
I do agree that many need no PMRT. I think with the way the guidelines are written now, if we don’t treat and there is a recurrence, medicolegally we may have an issue. So, I thought a balance was just doing CW RT. Or very low coverage of nodes to meet constraints. I don’t know if that’s the best approach, but it makes sense in my head.
Thanks! Just curious- in your textual example of a low risk pT2N1 patient you state PMRT is likely minimally beneficial (I agree, see eg SUPREMO). Yet your flowchart algorithm treats these patients always? You’d just do CW alone if deescalating?
That’s a great and fair question.
I do agree that many need no PMRT. I think with the way the guidelines are written now, if we don’t treat and there is a recurrence, medicolegally we may have an issue. So, I thought a balance was just doing CW RT. Or very low coverage of nodes to meet constraints. I don’t know if that’s the best approach, but it makes sense in my head.
B-51 exceptions
HR+/HER2- + adverse breast pathology (ypT2-3, extensive LVI, G3)
Is there typo? HR+/HER2- maybe HR-/HER2+?