Advances in radiation therapy for early stage breast cancer

Radiation therapy plays an important role in the multidisciplinary treatment of early stage breast cancer. While breast conservative treatment has become an established strategy, recent clinical investigations focus mainly on the possibility of modification to the standard practice, including the significance of tumor bed boost after whole breast irradiation, the criteria for low-risk patients not to receive adjuvant radiotherapy after breast conservative surgery and the feasibility of partial breast irradiation. Post-mastectomy radiotherapy to the chest wall and regional lymph nodes in high-risk patients has been proved to reduce the local-regional recurrence by 2/3. However, only a few trials support the improvement of survival, and significant controversy exists concerning the role of post-mastectomy radiotherapy in intermediate-risk patients. Current review summarizes the advances and controversies stated above for the treatment of early stage breast cancer.