by M. Dzhugashvili,
L. Veldeman, A.M. Kirby
The Breast: VOLUME 69, P299-305, JUNE
2023 (Published:March 17, 2023)
Abstract
Given that most local relapses of breast cancer occur
proximal to the original location of the primary, the delivery of additional
radiation dose to breast tissue that contained the original primary cancer
(known as a “boost”) has been a standard of care for some decades. In the
context of falling relapse rates, however, it is an appropriate time to
re-evaluate the role of the boost. This article reviews the evolution of the
radiotherapy boost in breast cancer, discussing who to boost and how to boost
in the 2020s, and arguing that, in both cases, less is more.
Highlights
•Delivery of additional RT dose to breast tumour bed has a
sound pathological basis.
•Breast boost local relapse benefits vary according to
clinicopathological risk factors.
•Young age, high grade & triple negative phenotype are
key eligibility criteria.
•There is no survival benefit from a tumour bed boost in
breast RT.
•The boost target volume and treatment burden should be
minimised.
