Partial breast irradiation

Adjuvant whole breast radiotherapy after breast conserving surgery has been the standard of care in the UK for many years and has been shown to halve the risk of breast cancer recurrence and reduce the risk of breast cancer death. However, breast radiotherapy increases the risk of ischaemic heart disease and second cancers and, in addition, causes cosmetic changes to the breast including breast shrinkage and texture changes. With rates of local tumour relapse in women with early breast cancer falling, the challenge in breast radiotherapy research has been to find treatments that maintain efficacy while reducing morbidity and improving patient convenience. Most breast cancer recurrences occur in the vicinity of the original tumour and, as such, there has been great interest in investigating techniques that reduce the volume of breast tissue irradiated in women at low risk of recurrence, so-called partial breast irradiation (PBI). This article will review PBI techniques, the evidence for their use and the selection of appropriate patients.

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