DISCLOSURES: Dr. Jagsi is on the Medical Advisory Board of Eviti, Inc.; she is the recipient of active grants from National Institutes of Health, the American Cancer Society, the National Comprehensive Cancer Network, the Burroughs-Wellcome/Alliance for Academic Internal Medicine, and the Breast Cancer Research Foundation; and she has received support for drug and distribution only from Abbott Pharmaceuticals for an investigator-initiated study.
Progress and controversies: Radiation therapy for invasive breast cancer
Version of Record online: 2 DEC 2013
© 2013 American Cancer Society, Inc.
CA: A Cancer Journal for Clinicians
Volume 64, Issue 2, pages 135–152, March/April 2014
How to Cite
Jagsi, R. (2014), Progress and controversies: Radiation therapy for invasive breast cancer. CA: A Cancer Journal for Clinicians, 64: 135–152. doi: 10.3322/caac.21209
- Issue online: 18 MAR 2014
- Version of Record online: 2 DEC 2013
- Manuscript Accepted: 30 SEP 2013
- Manuscript Revised: 27 SEP 2013
- Manuscript Received: 2 AUG 2013
- breast cancer;
- radiation therapy;
- breast-conserving therapy;
- postmastectomy radiation;
- partial breast irradiation;
- intensity-modulated radiotherapy
Radiation therapy is a critical component of the multidisciplinary management of invasive breast cancer. In appropriately selected patients, radiation not only improves local control, sparing patients the morbidity and distress of local recurrence, but it also improves survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. In recent years, considerable progress has been made toward improving our ability to select patients most likely to benefit from radiotherapy and to administer treatment in ways that maximize clinical benefit while minimizing toxicity and burden. This article reviews the role of radiation therapy in invasive breast cancer management, both after breast-conserving surgery and after mastectomy. It focuses particularly on emerging evidence that helps to define the clinical situations in which radiotherapy is indicated, the appropriate targets of treatment, and optimal approaches for minimizing both the toxicity and the burden of treatment, all in the context of the evolving surgical and systemic management of this common disease. It includes a discussion of new approaches in breast cancer radiotherapy, including hypofractionation and intensity modulation, as well as a discussion of promising avenues for future research. CA Cancer J Clin 2014;64:135–152. © 2013 American Cancer Society.