Sophisticated radiotherapy with optimal surgery is the way forward.
OBJECTIVE
Radiotherapy has been one of the cornerstones of treatment for breast cancer for more than a century and has contributed to conservation of the breast and improved locoregional control after mastectomy. This review assesses the most recent evidence generated by clinical scientists in the field of radiotherapy for breast cancer.


RESULTS
Results from mature trials investigating the role of radiotherapy in breast cancer treatment and the publication of meta-analyses of treatment effects have shown that in addition to improvements in local control, a survival benefit is obtained in several disease settings. These include breast-conserving therapy and postmastectomy radiotherapy. Further, improved diagnostic abilities and surgical techniques, together with advances in treatment delivery, will help to increase the therapeutic ratio of radiotherapy.


CONCLUSIONS
There is increasing evidence for long-term benefits of radiotherapy for breast cancer and a reduction in the risks of late side effects in recent decades. This can have a profound impact on clinical practice in the future, leading to a broadening and individualizing of the indications for radiotherapy and improvements in patient survival.
Russell
Nicola S
NS
Department of Radiotherapy, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. russell@nki.nl
Bartelink
Harry
H
D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D018714:Radiotherapy, Adjuvant