A 65-year-old woman with a 1.2 cm ER-positive, HER2-negative, node-negative invasive ductal carcinoma undergoes breast-conserving surgery with negative margins. She is postmenopausal and has no comorbidities. According to the PRIME II trial, which statement about adjuvant radiotherapy is correct?
- A Radiotherapy is mandatory regardless of risk factors
- B Radiotherapy can be safely omitted in this low-risk group ✓
- C Radiotherapy is indicated only if margins are positive
- D Radiotherapy should be replaced by chemotherapy
Correct answer: B. Radiotherapy can be safely omitted in this low-risk group
Explanation
The PRIME II trial demonstrated that omission of adjuvant radiotherapy in low-risk patients, age 65 or older, T1, ER-positive, node-negative, margins negative, results in a small increase in local recurrence but no difference in overall survival. Radiotherapy can be safely omitted in this group after discussion.
Reference: Harrison Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.