From the Northwestern Memorial Hospital, Chicago, IL
Author's disclosure of potential conflicts of interest is found at the end of this article.
Address reprint requests to Krystyna Kiel, MD, Northwestern Memorial Hospital, 201 E. Huron Street, LC 178, Chicago, IL 60611; e-mail: kkiel{at}nmh.org
Overview: Radiation therapy (RT) after margin-negative excision of invasive breast cancer decreases the risk of ipsilateral breast recurrence and reduces cancer-related mortality. Questions have arisen as to whether all patients need breast RT after excision and as to whether conventional methods of RT are required. RT is recommended even after a pathologic complete response to neoadjuvant chemotherapy. Older patients with low-risk breast cancer may be sufficiently treated with only hormone therapy — without breast RT — after excision. Alternatives to conventional RT include partial-breast accelerated treatment (currently under study) and accelerated whole-breast RT. Both methods can reduce the time and cost associated with RT. New technology in the planning and delivery of RT is likely to increase the complexity and cost of treatment but may result in improved tolerance and decreased toxicity.
