Michelle.
Yes, both my breast surgeon and my breast oncologist recommended that I have the radiation. They decided that I should not have Chemotherapy because of my immune disease. In my case the Chemotherapy could do more harm than good.

A portion of my path report was similar to yours. Positive for CK7, pan keratin and expressing p40, CK5/6 and p63. My report says these features are consistent with squamous carcinoma.

You asked about the perineural invasion and all that I know is that my cancer invaded large nerves. I can't find much information on this because of the rarity of it. However, I did read that PNI could be used as an independent poor prognostic indicator in patients with invasive breast carcinoma. It's been almost 4 years since my lumpectomy surgery, and I have not had a metastasis so that's a good thing.

I have never heard that cancer care is moving away from radiation so maybe someone else who knows more than I do could respond to that question.

I can't find much information on perineural invasion in breast cancer. If anyone reading this knows of a site that has information on this, I would appreciate it if you would let me know.
Thanks
Katrina