Radiotherapy in breast cancer

Radiotherapy is one of the three modalities used in the primary treatment o f breast cancer. For patients with ductal carcinoma in situ after complete resection, adjuvant radiotherapy permits breast-sparing treatment and incre ases the event-free survival. Radiotherapy is mandatory after breast-sparin g excision of localized invasive carcinomas and reduces the rate of local r ecurrence, albeit without affecting overall survival. Currently the data do not permit identification of subgroups of patients with invasive breast ca ncer after breast-sparing surgery in whom adjuvant radiotherapy could be de clined. High-risk patients benefit from locoregional radiotherapy. Modern r adiation techniques are no longer associated with cardiac morbidity and mor tality. The optimal sequence of adjuvant radiotherapy and chemotherapy is u nclear. Delayed radiotherapy is associated with an increased risk of local recurrence whereas delayed chemotherapy is associated with an increased ris k of distant recurrence.