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PMRT Indications — SCE Medical Oncology MCQ

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EasyBreast CancerPMRT IndicationsSCE Medical Oncology

A 70-year-old woman who underwent mastectomy for a T4 N2 breast cancer asks whether she needs post-mastectomy radiotherapy (PMRT). What are the indications for PMRT?

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Correct answer: A — PMRT is recommended for tumours >5 cm (T3-4), ≥4 positive lymph nodes, involved resection margins, or locally advanced presentations — it reduces locoregional recurrence and improves survival

The EBCTCG meta-analysis established that PMRT reduces locoregional recurrence and breast cancer mortality in patients with ≥4 positive nodes and/or T3-T4 tumours. NICE NG101 recommends PMRT for: ≥4 positive axillary nodes, T3-T4 tumours, positive surgical margins, and locally advanced presentations. The role of PMRT for 1-3 positive nodes is supported by the Danish/BCIRG-005 data. PMRT includes chest wall ± regional nodes (axilla, supraclavicular fossa, internal mammary chain).

Reference: NICE NG101; EBCTCG PMRT meta-analysis Lancet 2014; ESMO 2024 Early Breast Cancer