Partial Breast Irradiation for Early-Stage Breast Cancer: Advances, Challenges, and Future Directions-A Narrative Review

Qadir, A; Singh, N; Chui, A; Chao, M; Uribe, S; Foroudi, F

Author(s): Qadir, A; Singh, N; Chui, A; Chao, M; Uribe, S; Foroudi, F;
Details: Publication Year 2025-05-22,Volume 11,Issue #6,Page 59
Journal Title: Tomography
Publication Type: Review
Abstract: Advances in breast cancer treatment have shifted the focus from maximizing local control to balancing oncologic efficacy with treatment de-escalation and toxicity reduction. Whole-breast irradiation (WBI) following breast-conserving surgery remains the standard of care, but with up to 90% of recurrences occurring near the tumor bed, partial breast irradiation (PBI) has emerged as a viable alternative. Large randomized controlled trials (such as IMPORT LOW, Florence, and GEC-ESTRO) have demonstrated comparable ipsilateral breast tumor recurrence (IBTR) rates between PBI and WBI, reinforcing its oncologic safety in well-selected patients. However, challenges remain in optimizing fractionation schedules, refining patient selection, and minimizing late toxicity. Recent innovations, including MRI-guided radiotherapy (MRgRT) and neoadjuvant PBI, offer improved tumor targeting, real-time plan adaptation, and enhanced normal tissue sparing. These advancements hold promise for further reducing radiation-related morbidity and improving cosmetic outcomes. As PBI progresses, integrating novel imaging modalities and hypofractionated regimens will be crucial to refining protocols. This review synthesizes the latest evidence on PBI techniques, clinical outcomes, and emerging technologies to guide future research and clinical decision-making in precision breast radiotherapy.
Keywords: Humans; Female; *Breast Neoplasms/radiotherapy/diagnostic imaging/pathology; Magnetic Resonance Imaging/methods; *Radiotherapy, Image-Guided/methods; Neoplasm Staging; Breast/diagnostic imaging/radiation effects; Neoplasm Recurrence, Local; Radiotherapy, Adjuvant/methods; Mastectomy, Segmental; breast cancer; magnetic resonance imaging-guided radiotherapy; radiotherapy; review
Department(s): Radiation Therapy
Publisher's Version: https://doi.org/10.3390/tomography11060059
Open Access at Publisher's Site: https://doi.org/10.3390/tomography11060059
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-08-08 07:40:12

Last Modified: 2025-08-08 07:42:02