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Multimodality Treatment De-Intensification in Low-Risk Breast Cancer: What Are the Limits?
This is a case-based panel activity, with a surgeon, a medical oncologist and a radiation oncologist. Each speaker reviews the current and ongoing studies addressing treatment de-intensification in their area of expertise. The surgery discussion focuses on omission of axillary surgery and appropriate patient selection for this approach. The medical oncologist discusses endocrine therapy options including aromatase inhibitors and tamoxifen (including “baby tam” low dose tamoxifen), and also addresses the issue of endocrine therapy adherence. Finally, the radiation oncologist presents data regarding radiation de-intensification and the ongoing studies evaluating the option of radiation without endocrine therapy. At the end of the presentations, the moderator presents a series of cases and each panelist describes their treatment recommendation and the rationale. At the end, a summary of salient points are provided by the moderator.
Topics:
- A Surgical Oncology Perspective
Alistair Thompson, MD, MB, ChB, FRSCEd, BSc(Hons), FACS - Radiotherapy De-Escalation and Options for Radiation Monotherapy: The Radiation Oncology Perspective
Naamit Kurshan Gerber, MD - The Medical Oncology Perspective
Jennifer Y. Sheng, MD - Q and A
Jean L. Wright, MD, FASTRO - Moderator
Full Panel
This activity is available from April 29, 2025, through 11:59 p.m. Eastern time on April 28, 2027.
The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.
Target Audience
The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons, physicists, nurses, radiation therapists, radiation dosimetrists and residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Identify patients who may safely avoid sentinel lymph node biopsy.
- Understand the range of endocrine therapy approaches that can be considered for patients with low-risk breast cancer.
- Know the data in support of, as well as the existing studies that evaluate the option of radiation without endocrine therapy for selected patients.
- Jean L. Wright, MD, FASTRO, is employed by Johns Hopkins University School of Medicine and the National Institutes of Health. Dr. Wright receives grant/research funding and salary support from Oncospace and the Prostate Cancer Foundation. Dr. Wright receives honoraria from ASTRO for work as an APEx surveyor and from Elsevier Journals for work as an editor. Dr. Wright receives compensation/payment from UpToDate. Dr. Wright is an oral board examiner with the American Board of Radiology and serves as Chair of the Clinical Affairs and Quality Committee with ASTRO.
- Alastair Thompson, MD, MB, ChB, FRCSEd, BSc(Hons), FACS, is employed by Baylor College of Medicine. Dr. Thompson serves as Co-Chair of the Locoregional Working Group for the Translational Breast Cancer Research Consortium and serves as Co-Chair of the NCI Task Force with the Breast Oncology Local Disease Task Force.
- Jennifer Y. Sheng, MD, is employed by Johns Hopkins University.
- Naamit Kurshan Gerber, MD, is employed by New York University Grossman School of Medicine/NYU Langone Health. Dr. Gerber receives grant/research funding from PreludeDx and honoraria from the John Theurer Cancer Center. Dr. Gerber is a member of the ASTRO APBI Guidelines Committee.
The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Available Credit
- 1.25 AMA PRA Category 1 Credit™The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 Certificate of AttendanceThis activity was designated for 1.25 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
- Nonmember: $149
- Member: $99
- Member-in-Training: $49
- Student/Graduate Student/PGY-1 Member: $49
- Postdoctoral Fellow Member: $49
If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date.
Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.
The activity and its materials will only be available on the ASTRO website until April 28, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.
Required Hardware/software
One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.