Hypofractionation should be the new ‘standard’ for radiation therapy after breast conserving surgery

Hypofractionated whole breast radiation therapy following breast conserving surgery (BCS) has been used in many institutions for several decades. Four randomized trials with 5–10-year follow-up, have demonstrated equivalent local control, cosmetic and normal tissue outcomes between 50 Gy in 25 fractions and various hypofractionated RT prescriptions employing 13–16 fractions. Indirect evidence suggests that hypofractionated RT may also be safe and effective for regional nodal RT. In the face of equivalent outcomes, patient convenience and health care utilization benefits, hypofractionated RT should be the new ‘standard’ following BCS.