PMRT: Please Mind Randomized Trials

A 44-year-old woman with 2 synchronous left upper–outer quadrant high-grade estrogen receptor (ER)–positive, progesterone receptor–positive, HER2-negative pT1c pN0(i+)(sn) breast cancers undergoes mastectomy and sentinel lymph biopsy, followed by adjuvant chemotherapy for an OncotypeDx (Genomic Health, Redwood City, CA) Recurrence Score (RS) of 45 (1). We estimate her 10-year risk of locoregional relapse (LRR) without postmastectomy radiation therapy (PMRT) to be <6%. In a secondary analysis of National Surgical Adjuvant Breast and Bowel Project B-28, women with ER-positive pN1 breast cancer treated with mastectomy, anthracycline-based chemotherapy, and tamoxifen without PMRT had low rates of LRR, regardless of the OncotypeDx RS (2).

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