Hypofractionated versus conventionally fractionated radiotherapy for breast cancer in patients with reconstructed breast

Abstract

Breast cancer (BC) is the most prevalent and destructive tumor in developing countries. The implementation of mammography screening programs has enabled access to appropriate therapeutic interventions, including adjuvant endocrine therapy and breast-conserving surgery; earlier diagnosis translates into a wider survival-rate range, making hypofractionated radiotherapy (HFRT) the preferred option. This review examines the current literature comparing the two radiation therapies, HFRT and conventional radiotherapy (CR), with reconstructed breasts, focusing on efficacy, toxicity, cosmetic outcomes, quality of life (QOL), and cost-effectiveness. A comprehensive literature search was conducted using major scientific databases, including PubMed, Scopus, Web of Science, and Google Scholar. The search focused on articles published primarily in English, from 2010 to 2024, and the period is about 15 years. The following search terms and Boolean operators were used: "hypofractionated radiotherapy" OR "hypofractionation" AND "breast cancer" AND "toxicity" OR "complications" OR "reconstruction" OR "quality of life" OR "HFRT versus CFRT" OR "intensity-modulated radiation therapy" OR "proton therapy". CR can be safely replaced with HFRT in terms of overall survival and local recurrence rates. HFRT is associated with lesser risks of both acute and chronic side effects, breast complications, increased patient satisfaction, and reduced breast problems. In addition, new radiotherapy modalities, such as intensity-modulated radiation therapy, have shown great potential in targeting tumors. In treating BC, HFRT is gradually becoming standard, especially for patients who undergo reconstruction after surgery. Its low toxicity and equal effectiveness make it a key element in improving the QOL of BC survivors. It is recommended that future studies focus on long-term outcomes to provide better care to patients.

Keywords

breast cancer / radiotherapy / hypofractionated radiotherapy / conventional radiotherapy / breast reconstruction surgery

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