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RT Boost Breast — SCE Medical Oncology MCQ

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ModerateBreast CancerRT Boost BreastSCE Medical Oncology

A 60-year-old woman completes BCS for a 20 mm grade 2 ER+ breast cancer. She asks about the radiation boost to the tumour bed. When is a boost recommended after whole-breast RT?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — A boost (10-16 Gy) to the tumour bed after WBRT is recommended for women at higher risk of local recurrence — age ≤50, high grade, close margins, LVSI; the EORTC boost trial showed a 50% relative reduction in local recurrence

The EORTC 22881-10882 boost trial demonstrated that a 16 Gy boost to the tumour bed after WBRT reduced local recurrence by approximately 50% relative risk. The absolute benefit is greatest in women ≤50 years (highest baseline recurrence risk). NICE NG101 recommends discussing a boost for: age ≤50, high grade (3), close margins, LVSI. For older women with low-risk tumours, the absolute benefit is small and the boost may be omitted. Boost techniques include electron beam, photon mini-tangents and brachytherapy.

Reference: NICE NG101; EORTC boost trial Bartelink et al Lancet Oncol 2015; ESMO 2024