Advances in external radiotherapy for breast cancer

In the adjuvant setting, whole breast radiotherapy is the standard of care. Quality assurance (QA) is required in all steps before the start of irradiation using a relatively standardized 3D-conformal technique. The use of new advanced radiation technology and recent devices is in question for increasing the benefit/risk ratio. Currently, many aspects such as QA and indications have to be defined before the routine use of these techniques for curing many cancers including breast cancer. In breast cancer, feasibility of new techniques have been demonstrated in series that included a small number of patients. The challenge is to demonstrate their impact on long-term toxicity decrease, better outcome and to determine the subgroups of patients who will benefit in the context of the association of innovative therapies.