De-intensification of adjuvant radiotherapy to breast/chest wall in early breast cancer (EBC) patients achieving a pathological complete response (pCR) to neoadjuvant chemotherapy (NACT)

We would appreciate your expert opinions and completion of the below survey regarding the feasibility of a trial evaluating omission of adjuvant therapy to the breast/chest wall (CW) following pathological complete response (pCR) (excluding residual DCIS or ITC ie ypT0ypN0) to neoadjuvant chemotherapy in EBC.

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* 1. Specialty?

Oncology

Breast Surgery

Other (please specify)

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* 2. Grade

Surgical Consultant

Oncology Consultant

Associate specialist

Trainee

Other (please specify)

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* 3. Region?

North West

North East

Midlands

East of England

South West

London

Wales

Scotland

Northern Ireland

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* 4. There is a need for a prospective RCT evaluating de-intensification of adjuvant radiotherapy to the breast/CW in EBC patients who have achieved pCR (excluding DCIS and ITC/micromets)?

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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* 5. Would you consider entering an EBC patient in to a trial where the omission of breast/CW radiotherapy in a patient with pCR post NACT Ie. (ypT0ypN0), is one of the arms in the trial?

Yes

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* 6. What would your trial inclusion criteria be?

ER+HER2-

ER+HER2+

ER-HER2+

ER-HER2-

Age-49 years

50-69 years (if post-menopausal)

> 70 years

T1-2 N0 disease only

T1-T3 N0 Disease only

N1 (0-2 LNs)

Only left sided breast cancer

Other (please specify)

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* 7. Would you consider entering a patient into a trial of omission of breast/CW and axillary radiotherapy, for a clinically node negative axilla pre-NACT, who has pCR in breast and axilla (ypT0ypN0) but evidence of NACT-related changes in 1-3 nodes?

Yes

Question Title

* 8. What would your exclusion criteria be?

ER+HER2-

ER+HER2+

ER-HER2+

ER-HER2-

Invasive lobular breast cancer

Bilateral breast cancer

Evidence ITC/micrometastasis or pre-invasive disease on histology (post-NACT)

BRCA1/2 or other high risk mutation

Clinically node positive disease prior to NACT

Evidence of nodal fibrosis post-operatively (1-3 nodes)

Breast cancer within previous 5 years

Other (please specify)

De-intensification of adjuvant radiotherapy to breast/chest wall in early breast cancer (EBC) patients achieving a pathological complete response (pCR) to neoadjuvant chemotherapy (NACT)

Question Title

* 1. Specialty?

Question Title

* 2. Grade

Question Title

* 3. Region?

Question Title

* 4. There is a need for a prospective RCT evaluating de-intensification of adjuvant radiotherapy to the breast/CW in EBC patients who have achieved pCR (excluding DCIS and ITC/micromets)?

Question Title

* 5. Would you consider entering an EBC patient in to a trial where the omission of breast/CW radiotherapy in a patient with pCR post NACT Ie. (ypT0ypN0), is one of the arms in the trial?

Question Title

* 6. What would your trial inclusion criteria be?

Question Title

* 7. Would you consider entering a patient into a trial of omission of breast/CW and axillary radiotherapy, for a clinically node negative axilla pre-NACT, who has pCR in breast and axilla (ypT0ypN0) but evidence of NACT-related changes in 1-3 nodes?

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* 8. What would your exclusion criteria be?

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* 9. Comments