Present clinical practice of breast cancer radiotherapy in Italy: a nationwide survey by the Italian Society of Radiotherapy and Clinical Oncology (AIRO) Breast Group

Radiol Med. 2020 Jul;125(7):674-682. doi: 10.1007/s11547-020-01147-5. Epub 2020 Feb 20.


Aims: To investigate the present attitude of the Italian Radiation Oncologists in the management of breast cancer (BC) concerning hypofractionated radiotherapy (hRT), partial-breast irradiation (PBI), re-irradiation (rRT) and radiotherapy after neoadjuvant chemotherapy (post-NAC RT).

Methods: A nationwide, 21-point questionnaire was distributed online via SurveyMonkey.

Results: Seventy-four Italian Radiotherapy Centers answered to the survey. In most cases, the responding centers treated more than 100 BC patients/year between January 2016 and December 2017. Almost half of responding centers (49%) treated patients with hRT, out of these, 95% as routine practice for early-stage BC. Dose prescriptions ranged between 39 and 45 Gy indicating a high use of moderate hRT. The chest wall and regional lymph nodes were irradiated with hRT by 13% and 15% of the responding centers, respectively. PBI was used by 60% of responders, with different techniques. Only 0.6% of participants perform rRT after BC recurrence. Finally, only 11% of the interviewed centers responded to their attitude toward post-NAC RT, which, however, was indicated in 97% of patients after breast-conserving surgery.

Conclusions: This survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.

Keywords: AIRO; Breast cancer; Hypofractionated radiotherapy; Partial-breast irradiation; Radiotherapy and neoadjuvant therapy; Re-irradiation; Survey.

MeSH terms

  • Breast Neoplasms / radiotherapy*
  • Female
  • Humans
  • Italy
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Radiation Oncologists*
  • Societies, Medical
  • Surveys and Questionnaires