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Trials show older women with the lowest-risk breast cancers gain almost nothing from radiotherapy after lumpectomy. Yet most still get it. Track and reward omission.
LUMINA, PRIME II and IDEA show low local recurrence without radiotherapy in luminal A breast tumours in older women, yet most still receive it, so this idea makes omission the default pathway, with PAM50 genomic confirmation where needed, and tracks it as a quality metric. The evidence exists; the barrier is inertia and fee-for-service incentives, so payers would measure omission rate and five-year local recurrence. The test is a stepped-wedge implementation across cancer centres with registry follow-up. Being tested at scale, it addresses the bottlenecks Overdiagnosis and false alarms, Toxicity and quality of life are undervalued and Incentives reward me-too drugs and marginal gains.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms, Incentives reward me-too drugs and marginal gains.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms, HR-positive / HER2-negative breast cancer.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms, HR-positive / HER2-negative breast cancer.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms.
Shares Overdiagnosis in cancer, Overdiagnosis and false alarms.