Review Article| Volume 103, ISSUE 1, P187-199, February 2023

Radiation Treatment for Breast Cancer

Published:October 17, 2022DOI:


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        • Grubbe E.H.
        Priority in the therapeutic use of X-rays.
        Radiology. 1933; 21: 156-162
        • Bergom C.
        • Currey A.
        • Desai N.
        • et al.
        Deep inspiration breath hold: techniques and advantages for cardiac sparing during breast cancer irradiation.
        Front Oncol. 2018; 8: 87
        • Bergom C.
        • Kelly T.
        • Morrow N.
        • et al.
        Prone whole-breast irradiation using three-dimensional conformal radiotherapy in women undergoing breast conservation for early disease yields high rates of excellent to good cosmetic outcomes in patients with large and/or pendulous breasts.
        Int J Radiat Oncol Biol Phys. 2012; 83: 3
        • Mutter R.W.
        • Choi J.I.
        • Jimenez R.B.
        • et al.
        Proton therapy for breast cancer: a consensus statement from the particle therapy cooperative group bresat cancer subdommittee.
        Int J Radiat Oncol Biol Phys. 2021; 111: 337-359
        • EBCTG
        Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10801 women in 17 randomised trials.
        Lancet. 2011; 378: 1707-1716
        • Hughes K.S.
        • Schnaper L.A.
        • Bellon J.R.
        • et al.
        Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343.
        J Clin Oncol. 2013; 31: 2382-2387
        • Kunkler I.H.
        • Williams L.J.
        • Jack W.
        • et al.
        Prime 2 Randomised trial (postoperative radiotherapy in minimum-risk elderly): wide local excision and adjuvant hormonal therapy +/- whole breast irradiation in women =/> 65 years with early invasive breast cancer: 10 year results.
        Cancer Res. 2021; 81: GS2-03
        • Whelan T.J.
        • Pignol J.P.
        • Levine M.N.
        • et al.
        Long-term results of hypofractionated radiation therapy for breast cancer.
        N Engl J Med. 2010; 362: 513-520
        • Haviland J.S.
        • Owen J.R.
        • Dewar J.A.
        • et al.
        The UK standardisation of breast radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials.
        Lancet Oncol. 2013; 14: 1086-1094
        • Shah C.
        • Al-Hilli Z.
        • Vicini F.
        Advances in breast cancer radiotherapy: implications for current and future practice.
        JCO Oncol Pract. 2021; 17: 697-706
        • Smith B.D.
        • Bellon J.R.
        • Blitzblau R.
        • et al.
        Radiation therapy for the whole breast: executive summary of an american society for radiation oncology (ASTRO) evidence-based guideline.
        Pracital Radiat Oncol. 2018; 8: 145-152
        • Brunt A.M.
        • Haviland J.S.
        • Wheatley D.
        • et al.
        Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial.
        Lancet. 2020; 395: 1613-1626
        • Brunt A.M.
        • Haviland J.S.
        • Syndenham M.
        • et al.
        Ten-year results of FAST: a randomized controlled trial of 5-fraction whole-breast radiotherapy for early breast cancer.
        J Clin Oncol. 2020; 38: 3261-3272
        • Krug D.
        • Baumann R.
        • Combs S.E.
        • et al.
        Moderate hypofractionation remains the standard of care for whole-breast radiotherapy in breast cancer: considerations regarding FAST and FAST-forward.
        Strahlenther Onkol. 2021; 197: 269-280
      1. 2022;
        • Vicini F.A.
        • Cecchini R.S.
        • White J.R.
        • et al.
        Long-term Primary results of accelerated partial breast irradiation after breast-conserving surgery for early-stage breast cancer: a radndomised, phase 3, equivalence trial.
        Lancet. 2019; 394: 2155-2164
        • Correa C.
        • Harris E.E.
        • Leonardi M.C.
        • et al.
        Accelerated partial breast irradiation: executive summary for the update of an ASTRO evidence-based consensus statement.
        Pract Radiat Oncol. 2017; 7: 73-79
        • Meattini I.
        • Marrazzo L.
        • Calogero S.
        • et al.
        Accelerated partial-breast irradiation compared with whole-breast irradiation for early breast cancer: long-term results of the randomized phase III APBI-IMRT-florence trial.
        J Clin Oncol. 2020; 38: 4175-4183
        • Coles C.E.
        • Griffin C.L.
        • Kirby A.M.
        • et al.
        Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5-year Results from a multicentre, randomised, controlled, phase 3, non-inferiority trial.
        Lancet. 2017; 390: 1048-1060
        • Vaidya J.S.
        • Bulsara M.
        • Baum M.
        • et al.
        Long term survival and local control outocomes from a single dose targeted intraoperative radiotherapy durin gLumpectomy (TARGIT_IORT) for early breast cancer: TARGIT-A randomised clinical trial.
        BMJ. 2020; 370: m2836
        • Orecchia R.
        • Veronesi U.
        • Maisonneuve P.
        • et al.
        Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trial.
        Lancet Oncol. 2021; 22: 597-608
        • EBCTG
        Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast.
        J Natl Cancer Inst Monographs. 2010; 41: 162-177
        • Wapnir I.L.
        • Dignam J.J.
        • Fisher B.
        • et al.
        Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS.
        J Natl Cancer Inst. 2011; 103: 478-488
        • McCormick B.
        • Winter K.A.
        • Woodward W.
        • et al.
        Randomized phase III trial evaluating radiation following surgical excision for good-risk ductal carcinoma in situ: long-term report from NRG oncology/RTOG 0984.
        J Clin Oncol. 2021; 39: 3574-3582
        • Solin L.J.
        • Gray R.
        • Hughes L.L.
        • et al.
        Surgical excision without radiation for ductal carcinoma in situ of the breast: 12-year results from the ECOG-ACRIN E5194 study.
        J Clin Oncol. 2015; 33: 2938-2944
        • Solin L.J.
        • Gray R.
        • Baehner F.L.
        • et al.
        A multigene expression assay to predict local recurrence risk for ductal carcinoma in situ of the breast.
        J Natl Cancer Inst. 2013; 105: 701-710
        • Weinmann S.
        • Leo M.C.
        • Francisco M.
        • et al.
        Validation of a ductal carcinoma in situ biomarker profile for risk of recurrence after breast-conserving surgery with and without radiotherapy.
        Clin Cancer Res. 2020; 26: 4054-4063
        • EBCTG
        Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomized trials.
        Lancet. 2014; 383: 2127-2135
        • Whelan T.J.
        • Olivotto I.A.
        • Parulekar W.R.
        • et al.
        Regional nodal irradiation in early-stage breast cancer.
        N Engl J Med. 2015; 373: 307-316
        • Poortmans P.M.
        • Weltens C.
        • Fortpied C.
        • et al.
        Internal mammary and medial supraclavicular lymph node chain irradiation in stage I-III breast cancer (EORTC22922/10925): 15-year results of a randomised, phase 3 trial.
        Lancet Oncol. 2020; 21: 1602-1610
        • Rutgers E.
        • Donker M.
        • Poncet C.
        • et al.
        Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer patients: 10 year follow up results of the EORTC AMAROS trial (EORTC 10981/22023).
        Cancer Res. 2019; 79 (GS4–01)
        • Giuliano A.E.
        • Ballman K.V.
        • McCall L.
        • et al.
        Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis the ACOSOG Z0011 (Alliance) randomized clinical trial.
        JAMA. 2017; 318: 918-926
        • Jagsi R.
        • Chadha M.
        • Moni J.
        • et al.
        Radiation field design in the ACOSOG Z0011 (Alliance) trial.
        J Clin Oncol. 2014; 32: 3600-3606
        • Kim Y.B.
        • Byun H.K.
        • Kim D.Y.
        • et al.
        Effect of elective internal mammary node irradiation on disease-free survival in women with node-positive breast cancer.
        JAMA Oncol. 2022; 8: 96-105
        • Taylor C.
        • Correa C.
        • Duane F.K.
        • et al.
        Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
        J Clin Oncol. 2017; 35: 1641-1649
        • Clarke M.
        • Collins R.
        • Darby S.
        • et al.
        Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials.
        Lancet. 2005; 366: 2087-2106
        • Warren L.E.
        • Miller C.L.
        • Horick N.
        • et al.
        The impact of radiation therapy on the risk of lymphedema after treatment for breast cancer: a prospective cohort study.
        Int J Radiat Oncol Biol Phys. 2014; 88: 565-571
        • Ho A.
        • Hu Z.
        • Mehrara B.
        • et al.
        Radiotherapy in the setting of breast reconstruction: types, techniques, and timing.
        Lancet Oncol. 2017; 18: e742-e753
        • Jordan R.M.
        • Oxenberg J.
        Breast cancer conservation therapy. [Updated 2021 Sep 22]. In: StatPearls [Internet]. Treasure Island (FL).
        StatPearls Publishing, 2022 (Available at:)