A 65-year-old woman undergoes a lumpectomy and sentinel lymph node biopsy and is found to have a 5 mm tubular cancer ER and PR positive and a negative sentinel lymph node. What adjuvant treatment should be recommended?

Generally, patients with small (<1 cm) breast cancers, which are pathologically node negative, are spared from chemotherapy. Radiation and hormonal therapy is indicated. Partial breast irradiation can be offered though there is no current randomized data to show the best modality of treatment (currently an ongoing NSABP/RTOG trial).