Adjuvant radiotherapy in the management of axillary node negative invasive breast cancer: a qualitative systematic review

Crit Rev Oncol Hematol. 2013 Apr;86(1):33-41. doi: 10.1016/j.critrevonc.2012.09.010. Epub 2012 Oct 22.


Purpose: To actualize and to detail guidelines used in technical radiotherapy and indications for innovative radiation technologies in early axillary node negative breast cancer (BC).

Methods: Dosimetric and treatment planning studies, phase II and III trials, systematic reviews and retrospective studies were all searched (Medline(®) database). Their quality and clinical relevance were also checked against validated checklists. A level of evidence was associated for each result.

Results: A total of 75 references were included. Adjuvant BC radiotherapy (50Gy/25 fractions/5 weeks followed by a tumor boost of 16Gy/8 fractions) is still the standard of care. Overall treatment time could be shortened for patients who present with low local relapse risk BC by using either hypofractionated whole breast irradiation; or accelerated partial breast irradiation. BC IMRT is not used in current practice.

Conclusion: Our group aimed to provide guidelines for technical and clinical applications of innovative BC radiation technologies.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Axilla
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Mastectomy, Segmental
  • Neoplasm Invasiveness
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Adjuvant
  • Tumor Burden