Radiotherapy of Breast Cancer—Professional Guideline 1st Central-Eastern European Professional Consensus Statement on Breast Cancer

Abstract

The international radiotherapy (RT) expert panel has revised and updated the RT guidelines that were accepted in 2020 at the 4th Hungarian Breast Cancer Consensus Conference, based on new scientific evidence. Radiotherapy after breast-conserving surgery (BCS) is indicated in ductal carcinoma in situ (stage 0), as RT decreases the risk of local recurrence (LR) by 50–60%. In early stage (stage I-II) invasive breast cancer RT remains a standard treatment following BCS. However, in elderly (≥70 years) patients with stage I, hormone receptor-positive tumour, hormonal therapy without RT can be considered. Hypofractionated whole breast irradiation (WBI) and for selected cases accelerated partial breast irradiation are validated treatment alternatives to conventional WBI administered for 5 weeks. Following mastectomy, RT significantly decreases the risk of LR and improves overall survival of patients who have 1 to 3 or ≥4 positive axillary lymph nodes. In selected cases of patients with 1 to 2 positive sentinel lymph nodes axillary dissection can be substituted with axillary RT. After neoadjuvant systemic treatment (NST) followed by BCS, WBI is mandatory, while after NST followed by mastectomy, locoregional RT should be given in cases of initial stage III–IV and ypN1 axillary status.

Modern Breast Cancer Surgery 1st Central-Eastern European Professional Consensus Statement on Breast Cancer

“…In institutes where isotope labelling is not possible, the alternative methods presented here are indeed applicable, but, naturally, after proper validation. This is part 2 of a series of 6 publications on the first Central-Eastern European Professional Consensus Statements on Breast Cancer covering imaging diagnosis and screening (91), pathological diagnosis (92), surgical treatment (present paper), systemic treatment (93), radiotherapy (94) of the disease and related follow-up, rehabilitation and psycho-oncological issues (95).…”

Use of Diagnostic Imaging Modalities in Modern Screening, Diagnostics and Management of Breast Tumours 1st Central-Eastern European Professional Consensus Statement on Breast Cancer

“…This is part 2 of a series of 6 publications on the 1st Central-Eastern European Professional Consensus Statements on Breast Cancer covering imaging diagnosis and screening (present paper), pathological diagnosis ( 150 ), surgical treatment ( 151 ), systemic treatment ( 152 ), radiotherapy ( 153 ) of the disease and related follow-up, rehabilitation and psycho-oncological issues ( 154 ).…”

Long-Term Effects of Breast Cancer Therapy and Care: Calm after the Storm?

“…Postoperative RT is strongly recommended after BC conserving surgery [ 21 ]: whole-breast RT (WBRT) alone reduces by 15% the 10-year risk of any first recurrence (including locoregional and distant) and by 4% the 15-year risk of BC-related mortality [ 22 ]. Nevertheless, it is associated with several side effects that can persist over time.…”