Abstract
In recent years, there have been a number of small, yet notable practice changes in the delivery of postmastectomy radiation therapy (PMRT) in breast cancer patients. Herein, we describe the role of PMRT and its evolving delivery with hypofractionated regimens. The UK START trials and whole-breast hypofractionation studies established the safety and effectiveness of accelerated radiotherapy. This has inspired further investigations of similar principles in patients with reconstruction, acute and late toxicities associated with hypofractionated regimens, socioeconomic benefit, and evolving delivery techniques. Overall, results from clinical trials evaluating hypofractionation for RNI or PMRT appear promising despite the limited length of follow-up. Ongoing clinical trials will provide valuable data on the safety of hypofractionation in breast cancer patients with immediate reconstruction. Hypofractionation for PMRT represents high-quality care that is not only more convenient for patients but also more cost-effective for the healthcare system.
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