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Background <p>Recent results from randomized trials have transformed the concepts underlying the irradiation of localized breast cancer and have been incorporated into national and international guidelines.</p> Results <p>After the publication of the DBCG Skagen 1&#xa0;study, moderate hypofractionation remains the standard in adjuvant regional nodal irradiation for breast cancer. The FAST-Forward study has provided initial results on ultra-hypofractionation for regional nodal irradiation as a&#xa0;possible future alternative. The SUPREMO study showed that omitting radiotherapy after mastectomy and axillary dissection in patients with pT1–2, one to two positive lymph nodes, and a&#xa0;low-risk constellation is feasible. The SOUND and INSEMA studies demonstrated that omitting sentinel lymph node excision is possible in selected low-risk patients, raising new questions about the implications for adjuvant radiotherapy. The NSABP B‑51/RTOG 1304 study also provided important data on the de-escalation of adjuvant radiotherapy in early breast cancer with nodal remission after neoadjuvant chemotherapy.</p> Conclusion <p>Modern radiotherapy is undergoing continuous change with regard to indications, fractionation, and treatment concepts in breast cancer.</p>

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Update Strahlentherapie beim Mammakarzinom

  • 期刊论文

  • 发表日期：

    2026年4月15日

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  • Katharina Hintelmann,
  • David Krug

摘要

Background

Recent results from randomized trials have transformed the concepts underlying the irradiation of localized breast cancer and have been incorporated into national and international guidelines.

Results

After the publication of the DBCG Skagen 1 study, moderate hypofractionation remains the standard in adjuvant regional nodal irradiation for breast cancer. The FAST-Forward study has provided initial results on ultra-hypofractionation for regional nodal irradiation as a possible future alternative. The SUPREMO study showed that omitting radiotherapy after mastectomy and axillary dissection in patients with pT1–2, one to two positive lymph nodes, and a low-risk constellation is feasible. The SOUND and INSEMA studies demonstrated that omitting sentinel lymph node excision is possible in selected low-risk patients, raising new questions about the implications for adjuvant radiotherapy. The NSABP B‑51/RTOG 1304 study also provided important data on the de-escalation of adjuvant radiotherapy in early breast cancer with nodal remission after neoadjuvant chemotherapy.

Conclusion

Modern radiotherapy is undergoing continuous change with regard to indications, fractionation, and treatment concepts in breast cancer.