ArticleAdvances in radiation oncology2026
Ultrahypofractionated Partial Breast Reirradiation for Ipsilateral Breast Tumor Recurrence.
Article in Advances in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Purpose: Salvage mastectomy has traditionally been the standard treatment for ipsilateral breast tumor recurrence (IBTR) following breast-conserving therapy (BCT). Repeat lumpectomy followed by brachytherapy-based or hyperfractionated external beam partial breast reirradiation (PBrI) has emerged as an alternative in select patients. Ultrahypofractionated PBrI offers a potentially more convenient approach, but its use remains under investigation. This study evaluates the safety and feasibility of ultrahypofractionated PBrI following repeat lumpectomy. Methods and Materials: Twenty-five consecutively treated women with IBTR after prior BCT, including whole-breast irradiation, who underwent repeat lumpectomy followed by ultrahypofractionated PBrI between 2021 and 2025, were identified from a prospectively maintained, multicenter, single-institution database. Treatment consisted of 26 Gy in 5 daily fractions using volumetric modulated arc therapy; 2 patients received a simultaneous integrated boost to 30 Gy. Acute (<3 months) and chronic (>3 months) side effects (National Cancer Institute Common Terminology Criteria for Adverse Events v4.0), cosmetic outcome (Harvard scale), IBTR, regional and distant failure, and overall survival were assessed. Kaplan-Meier estimates analyzed time-to-event outcomes. Results: Median age at recurrence was 70 years, with a median interval of 16.6 years from initial treatment. At recurrence, most tumors were stage 0 to I (96%), grade 1 to 2 (88%), estrogen receptor-positive (92%), human epidermal growth factor receptor 2-negative, with a median size of 1.2 cm; 56% recurred in the same quadrant. Following PBrI, 1 patient experienced an IBTR, yielding a crude local control rate of 96%. No regional failure, distant failure, or death occurred. Acute side effects were grade 1 only, including dermatitis (44%), breast edema (12%), breast pain (8%), and fatigue (8%). Late side effects included grade 1/2 breast shrinkage (50%), fibrosis/induration (48%), edema (8%), and telangiectasia (4%). Cosmetic outcome was rated as excellent/good in 71%, and 13% experienced a decline to poor/fair after repeat BCT. Conclusions: Ultrahypofractionated PBrI following repeat lumpectomy appears to be well tolerated, with acceptable cosmetic outcomes and short-term cancer control in appropriately selected patients. Larger prospective studies are warranted to validate these findings.
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