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Crit Rev Oncol Hematol. 2013 Apr;86(1):33-41. doi: 10.1016/j.critrevonc.2012.09.010. Epub 2012 Oct 22.

Adjuvant radiotherapy in the management of axillary node negative invasive breast cancer: a qualitative systematic review.

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Radiation Oncology Department, Institut Gustave Roussy, Villejuif, France.



To actualize and to detail guidelines used in technical radiotherapy and indications for innovative radiation technologies in early axillary node negative breast cancer (BC).


Dosimetric and treatment planning studies, phase II and III trials, systematic reviews and retrospective studies were all searched (Medline(®) database). Their quality and clinical relevance were also checked against validated checklists. A level of evidence was associated for each result.


A total of 75 references were included. Adjuvant BC radiotherapy (50Gy/25 fractions/5 weeks followed by a tumor boost of 16Gy/8 fractions) is still the standard of care. Overall treatment time could be shortened for patients who present with low local relapse risk BC by using either hypofractionated whole breast irradiation; or accelerated partial breast irradiation. BC IMRT is not used in current practice.


Our group aimed to provide guidelines for technical and clinical applications of innovative BC radiation technologies.

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