RadOnc Smart Review

Our patient has finished lumpectomy and sentinel node biopsy for an early-stage, hormone receptor-positive breast cancer. We cover prognostic versus predictive markers and late recurrence, which endocrine drug and for how long, adherence, TAILORx, RxPONDER and MINDACT, and how radiation fits with CDK4/6 inhibitors and the order of treatments.Chapters00:00 Opening, the case and the board answer
03:37 Predictive markers and late recurrence
06:28 Which drug, how long, and adherence
09:44 TAILORx, RxPONDER and MINDACT
15:22 Radiation, CDK4/6 timing and sequencing
20:52 Traps, pearls, Board Blitz and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

Her sentinel node result is back. We cover node categories and the (sn) suffix, why we stage the axilla with surgery, NSABP B-32, SOUND and INSEMA, guidance for older women, Z0011 and IBCSG 23-01, AMAROS and SENOMAC, the axilla after mastectomy, and lymphedema.Chapters00:00 Opening, the case and the board answer
03:13 Node categories and the (sn) suffix
06:39 Surgical staging and NSABP B-32
10:22 SOUND and INSEMA
14:24 Guidance for older women
17:55 Z0011 and IBCSG 23-01
22:22 AMAROS, SENOMAC and ASCO guidance
26:29 After mastectomy: the evidence limits
30:23 Lymphedema and the changed fact
33:46 Traps, pearls and Board Blitz
37:30 Patient explanation and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

A woman with a small breast cancer asks whether keeping her breast means giving up survival. We cover why breast conservation works, who should not conserve, margins, multiple foci and MRI, oncoplastic surgery and the tumor bed, and mastectomy choices.Chapters00:00 Opening, recall and the board answer
02:44 Why conservation works
07:02 Who should not conserve
10:15 Margins, multiple foci and MRI
15:40 Oncoplastic surgery and the tumor bed
17:41 Mastectomy choices, traps and Blitz
22:36 Patient explanation and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

A full mock oral board on DCIS. The examiner presents a case and the candidate answers: workup, surgery and the axilla, a close margin, whole breast radiation and the boost, endocrine therapy, planning and follow-up. A sub-case tests whether radiation is standard for her, the trade-off, partial breast options, COMET and genomic assays, and the episode ends with a lightning round. Try to answer each question before the candidate does.Chapters00:00 Opening and the main case
01:53 Workup before surgery
03:22 Surgery and the axilla
05:10 The close margin
08:36 Whole breast radiation and the boost
12:10 No endocrine therapy for ER negative
13:38 Will radiation help me live longer?
14:57 Planning and plan review
17:09 Follow-up and the sub-case
18:10 Is radiation standard for her?
19:26 Quantifying the trade-off
21:14 Endocrine options and partial breast
23:45 COMET, assays and the lightning roundThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

A planning workshop for our DCIS patient. We cover her schedule and dose constraints, simulation and breath hold, when to simulate prone, contours, technique, the order of plan review and heart dose, then a drill that compares three plans.Chapters00:00 Opening, recall and the case
02:47 Her schedule and the constraint rule
06:18 Simulation and breath hold
10:11 When to simulate prone
13:03 Contours
18:10 Technique and review order
21:25 Board answer and heart dose
24:47 Drill: plans A, B and C
28:50 Escalation, traps and Board BlitzThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

After lumpectomy for DCIS, does she need weeks of daily radiation? We cover what radiation does and does not buy, endocrine therapy, who can skip radiation, the boost and fractionation, partial breast options, genomic assays and active monitoring.Chapters00:00 Opening, recall and the board answer
04:38 What radiation does and does not buy
09:25 Endocrine therapy
14:45 Who can skip radiation
19:35 The boost trial and fractionation
23:33 The boost guideline and partial breast
26:08 Assays and active monitoring
30:40 Changed facts, traps and Board Blitz
35:42 Patient explanation and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

A new patient opens the DCIS block. We cover microinvasion and why recurrence matters, workup and MRI, choosing the operation, margins and what to do with a close margin, when the axilla needs surgery, LCIS, and the common traps.Chapters00:00 Opening and the running case
04:49 Microinvasion and why recurrence matters
08:34 Workup, MRI and choosing the operation
13:54 Margins and the 2 mm rule
18:48 Close margin and the axilla
24:11 Mastectomy axilla, LCIS and traps
29:38 Pearls, Board Blitz and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

Before treatment starts, someone has to record where the cancer began. We cover the grammar of staging and why clinical and pathologic stage both matter, T and N categories, stage groups, when to stage the rest of the body, and who should have germline testing. We close with a treatment map that sets up the rest of the series.Chapters00:00 Opening and the running case
04:11 Clinical and pathologic staging
06:33 T categories and T4
08:53 N categories and stage groups
14:10 Systemic staging
17:40 Germline testing
19:43 The treatment map
24:53 Changed fact, traps and pearls
28:32 Board Blitz, patient talk and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

Our patient moves from a screening callback to a tissue diagnosis. We cover BI-RADS, the recall path and breast density, when MRI helps define extent, biopsy, clips and concordance. Then we read the pathology report the way an examiner does: histology, grade, lymphovascular invasion, ER, PR and ER-low, HER2 and HER2-low, Ki-67 and margins.Chapters00:00 Opening and the callback case
03:42 BI-RADS, the recall path and density
07:47 Extent of disease and breast MRI
11:48 Biopsy, clips and concordance
16:09 Histology, grade and LVI
20:36 ER, PR and ER-low positive
24:25 HER2, HER2-low and the retest
29:03 Ki-67, margins and the board answer
33:01 Traps, pearls, Board Blitz and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com

This series begins with one patient and her first abnormal mammogram. We build the anatomy and biology that every later decision rests on: the breast as an organ, axillary levels and lymph drainage, Halsted and NSABP B-04, and how stage and subtype shape when and where breast cancer relapses. We finish with traps, pearls and a Board Blitz.Chapters00:00 Opening, the case and the board answer
02:19 Breast anatomy and lesion location
04:45 Axillary levels and lymph drainage
07:42 Halsted, NSABP B-04 and failure patterns
09:50 Stage, subtype and relapse timing
13:32 Local control and distant risk
17:40 Traps, pearls, Board Blitz and closeThe patients in this episode are invented for teaching.For education only. This is not medical advice.Notes and practice oral boards: radoncsmartlearn.com