Hypofractionated Post-Mastectomy Radiation Therapy

Abstract Post-mastectomy radiation therapy (PMRT) is often delivered in patients with locally advanced breast cancer to optimize locoregional tumor control. Standard fractionation (SF), which is typically delivered over 5-7 weeks, is considered the standard of care in setting of PMRT. Modern data has helped to establish hypofractionated whole breast irradiation (HF-WBI), which consists of a 3-4 week regimen, as a new standard of care for early-stage breast cancer. HF-WBI has also laid the groundwork for the exploration of a hypofractionated approach in the setting of post-mastectomy radiation therapy (HF-PMRT). While HF-PMRT is not currently the standard of care, initial results from several HF-PMRT trials demonstrate its safety and efficacy. This article provides an overview of the major randomized trials that support the use of HF-PMRT for locally advanced breast cancer patients.