Image-guided de-escalation of treatment: the PROSPECT trial paradigm shift
Bruce Mann, Parkville / Australia
1. To consider the current treatment protocols for the omission of radiotherapy in early breast cancer (EBC).
2. To reflect on the nature of EBC, including the existence and potential importance of undiagnosed cancers occult on conventional imaging.
3. To differentiate minimal/mild BPE from moderate/marked BPE on breast MRI and predict how it will affect the identification of synchronous occult cancers, thereby impacting the ability to de-escalate treatment.
4. To adapt existing knowledge of local staging of breast cancers with MRI to enable identification of unifocal EBCs for which radiotherapy may be safely omitted and multifocal/centric disease for treatment intensification.