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March 11, 2021

Is It Time to Reevaluate Radiotherapy Omission in Older Patients With Favorable Early-Stage Breast Cancer?

Author Affiliations
  • 1Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois
  • 2Department of Radiation Oncology, New York Proton Center, New York
  • 3Department of Radiation Oncology, Ohio State University Comprehensive Cancer Center, Columbus
JAMA Oncol. 2021;7(7):965-966. doi:10.1001/jamaoncol.2021.0064

The role of adjuvant radiotherapy (RT) following breast-conserving surgery in early-stage breast cancer has been well established based on several landmark clinical trials in the 1970s.1,2 Subsequent studies3,4 have suggested that in a subgroup of patients, particularly older women with smaller estrogen receptor (ER)–positive tumors receiving antihormonal therapy, irradiation may not provide as compelling a clinically meaningful benefit. More recently, significant technical5 and practical6,7 advances in breast RT have been made, and an emphasis on individual patient-centric care has become the norm. Taken together, these factors beg the question: Is it time to reevaluate the practice of omitting RT in patients 65 years or older with favorable early-stage breast cancer?

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