Balloon-based brachytherapy was developed to simplify the brachytherapy technique and make accelerated partial breast irradiation more accessible to patients with breast cancer who are suitable candidates for this technique. Xoft Axxent (Xoft, Inc., Sunnyvale, CA) electronic brachytherapy is a novel method of accelerated partial breast irradiation that uses an electronic source to produce X-rays. Xoft Axxent treatment does not require a high-dose-rate afterloader unit or a shielded vault, unlike other brachytherapy techniques that use iridium-192, such as MammoSite brachytherapy. Xoft Axxent is associated with the delivery of less radiation to normal tissues, and increased high radiation dose regions or 'hot spots' to the target volume compared with treatment with the MammoSite device. Further research will be needed to determine subgroups of patients who might benefit from treatment with Xoft Axxent electronic brachytherapy.