Breast cancer

Educational Objective: Gain insight on when to use radiotherapy, when to boost, which fractionation schemes to use and which regions to target for patients with early triple-negative breast cancer (TNBC).

Specialty: Radiation oncology, Clinical oncology

Target Audience: CME (basic, intermediate); Residents (senior)

Latest update: January 2024

Background:

Treatment of early breast cancer is complex and involves a combination of local (surgery, radiotherapy) and systemic therapies. Radiotherapy has an established role in reducing the local relapses in patients with breast cancer.

TNBC has a more aggressive clinical course than other breast cancer subtypes, with an increased likelihood of locoregional recurrences, and also distant recurrence and deaths within the first 5 years of diagnosis. Among patients with TNBC, the risk of distant recurrence peaks at ~3 years [1]. In the past, this led to a preference of radical surgery and extensive radiotherapy. However, the introduction of more effective systemic therapies, with a shift from the adjuvant to the neoadjuvant setting, impacted the timing and extent of locoregional treatments.

This CME course only includes patients with TNBC. Breast size is to be considered acceptable for breast conservation in all cases, unless otherwise specified.

 

1. Dent R, Trudeau M, Pritchard KI, et al. Clin Cancer Res 2007;13:4429-34. PubMed