CPB Ljubljana 2018 course book

GEC-ESTRO Breast WG

RISK GROUPS FOR BOOST

LOW RISK INTERMEDIATE RISK HIGH RISK MEET ALL CRITERIA MEET ANY CRITERIA MEET ANY CRITERIA Age >50 Age > 50 and one factor: Positive margins Size ≤ 3cm - Size > 3cm Age ≤ 40 and one factor No triple negative - Triple negative - triple negative Clear margins ≥ 2mm - close margins <2mm - close margins <2mm EIC - - EIC+ - EIC + LVI - - LVI + pN 0 (sentinel orALND) - positive axilary nodes * Unicentric and unifocal - Multicentric/multifocal - after neoadjuvant therapy with residual tu Age >40 < 50 Age ≤ 40 without major risk criteria BOOST NOT NEEDED BOOST 10-16Gy BOOST ≥ 16 Gy

* In case of pN+ with ≤3 positive nodes, age >60 and no other risk factors to omit the boost is justifiable.

Polo A et al. Risk factors and state-of-the-art indications for boost irradiation in invasive breast carcinoma. Brachytherapy 2017; 16:552-564.