Patient factors

Suitable

Cautionary

Unsuitable

Age

≥60 y

50 - 59 y

<50 y

BRCA 1/2 mutation

Not present

Present

Pathologic factors

Tumor size

≤2 cm*

2.1 - 3.0 cm

>3 cm

T stage

T1

T0 or T2

T3-4

Margins

Negative by at least 2 mm

Close (<2 mm)

Positive

Grade

Any

LVSI

No**

Limited/focal

Extensive

ER status

Positive

Negative

Multicentricity

Unicentric only

Present

Multifocality

Clinically unifocal with total size ≤ 2.0 cm‡‡

Clinically unifocal with total size 2.1 - 3.0 cm‡‡

If microscopically multifocal > 3 cm in total size or if clinically multifocal

Histology

Invasive ductal or other favorable subtypes§

Invasive lobular

Pure DCIS

Not allowed

≤3 cm

If > 3 cm in size

EIC

Not allowed

≤3 cm

If > 3 cm in size

Associated LCIS

Allowed

Nodal factors

N stage

pN0 (i, i+)

pN1, pN2, pN3

Nodal Surgery

SN Bx or ALNDII II

None Performed

Treatment Factors

Neoadjuvant

Therapy

Not allowed

If used