Table 2.
ASTRO | GEC-ESTRO | ASTRO | GEC-ESTRO | ASTRO | GEC-ESTRO | |
Factor | Suitable | Low-risk | Cautionary | Intermediate-risk | Unsuitable | High-risk |
Patient factors | ||||||
Age (yr) | ≥ 60 | > 50 | 50-59 | 40-50 | < 50 | < 40 |
BRCA1/2 mutation | Not present | Not defined | Not present | Not defined | Present | Not defined |
Pathologic factors | ||||||
Tumor size (cm) | ≤ 2 | ≤ 3 | 2.1-3.0 | ≤ 3 | > 3 | > 3 |
T stage | T1 | T1-2 | T0 or T2 | T1-2 | T3-4 | T2 (> 3 cm), T3-4 |
Histology | IDC or other favorable subtypes | IDC, mucinous, tubular, medullary and colloid carcinoma | ILC allowed | ILC allowed | Any | Any |
Grade | Any | Any | Any | Any | Any | Any |
Pure DCIS | Not allowed | Not allowed | ≤ 3 cm | Allowed | > 3 cm | Any |
EIC | Not allowed | Not allowed | ≤ 3 cm | Not allowed | > 3 cm | Allowed |
Associated LCIS | Allowed | Allowed | Allowed | Allowed | Allowed | Allowed |
Multicentricity | Unicentric | Unicentric | Unicentric | Unicentric | Multicentric | Multicentric |
Multifocality | Clinically unifocal ≤ 2 cm | Unifocal | Clinically unifocal 2.1-3 cm | Multifocal (limited within 2 cm of the index lesion) | Clinically multifocal, > 3 cm | Multifocal (> 2 cm from the index lesion) |
LVSI | No | Not allowed | Limited/focal | Not allowed | Extensive | Allowed |
ER status | Positive | Any | Negative | Any | Any | Any |
Surgical margins | ≥ 2 mm | ≥ 2 mm | < 2 mm | < 2 mm | Positive | Positive |
Nodal factors | ||||||
N stage | pN0 (i-, i+) | pN0 | pN0 (i-, i+) | pN1mi, pN1a | ≥ pN1 | pNx, ≥ pN2a |
Nodal surgery | SN biopsy or ALND | None performed | ||||
Neoadjuvant therapy | Not allowed | Not allowed | Not allowed | Not allowed | If used | If used |
DCIS: Ductal carcinoma in situ; EIC: Extensive intraductal component; LCIS: Lobular carcinoma in situ; ASTRO: American Society for Radiation Oncology.