Radiation therapy is a standard therapeutic option in the post-operative setting for early breast cancer patients after breast conserving surgery, providing a substantial benefit in reducing the risk of local relapse with a consequent survival gain. Nevertheless, the reduction in the burden related to treatment is becoming crucial in modern oncology for both local and systemic therapies and investigational efforts are being put forward by radiations oncologists to identify a subset of women at very low risk to be potentially omitted from post-operative irradiation after breast conservation. Clinical factors, classical pathological parameters and new predictive scores derived from gene expression and next generation sequencing techniques are being integrated in the quest toward a reliable low-risk profile for breast cancer patients. We herein provide a comprehensive overview on the topic.
Keywords: Breast cancer; Breast conserving surgery; Elderly; Endocrine therapy; Low risk; Partial breast irradiation; Radiation oncology; Radiotherapy omission; Whole breast irradiation.
© 2020 Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.
Conflict of interest statementThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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