Radiotherapy of breast cancer-When and how much?

Background: Adjuvant radiotherapy is undergoing constant changes concerning the indications, treatment concepts and fractionation. Objective: To give an overview over the current concepts and developments in adjuvant radiotherapy for patients with breast cancer. Material and method: Semi-structured literature search. Results: Adjuvant radiotherapy reduces the local recurrence rate even in patients with low-risk breast cancer. Recent studies investigate the exact subtype classification. Partial breast irradiation has become established as a standard treatment and an alternative for patients with low-risk breast cancer. The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) meta-analysis supports the use of regional nodal irradiation while the National Surgical Adjuvant Breast and Bowel Project B-51 (NSABP B-51) suggests that de-escalation of locoregional radiotherapy may be possible for a subset of patients with stage ypN0. Moderate hypofractionation represents the gold standard and current study data also support its use in regional nodal irradiation and after implant reconstruction. Conclusion: Modern adjuvant radiotherapy for patients with breast cancer is a personalized and individualized treatment.