In reply to Chang et al.: Contouring guidelines for post-mastectomy radiotherapy a cry for international consensus

We congratulate Chang et al. for their recent publication detailing patterns of locoregional recurrence for breast cancer patients in the context of cooperative group contouring guidelines from RTOG and ESTRO [1]. The number of patients suffering recurrence outside of the smaller ESTRO but within the larger RTOG volumes was small for patients undergoing breast conserving surgery (3.6%), suggesting good concordance between the CTV volume recommendations; however, a significant percentage (28.9%) of local failures after mastectomy occurred outside of the smaller ESTRO but within the larger RTOG volumes.

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