Adjuvant radiotherapy in breast cancer

Locoregional external beam radiation therapy using linear accelerators is an essential component of a multimodal treatment concept with a curative intent after primary surgical therapy in non-invasive and locally confined invasive breast cancer. Its important role has been confirmed at the highest level of evidence by recent results of prospective randomized clinical trials as well large meta-analyses. Whole breast irradiation following breast-conserving surgery is an integral part of breast-conserving therapy, and the indications for postmastectomy radiation therapy have been clarified. It is the decisive prognostic factor determining local and locoregional tumor control as an important therapy goal. Moreover, as an independent prognostic factor, radiotherapy positively impacts overall survival. This effect is statistically visible only after >5 years. The positive impact is directly correlated with the primary tumor stage. It is more pronounced in cases of primary nodal involvement than in node-negative disease where it is also significant.