The changing landscape in radiotherapy for breast cancer: Lessons from long term follow-up in some European breast cancer trials.

This review describes the developments in the radiation treatment of breast cancer based on some randomized European trials during the past decades. It will focus on the relevance of long term follow-up in breast cancer patients, starting with the surprising and important change in treatment results during follow-up shown in a locally advanced breast cancer trial. Breast conserving therapy (BCT) in stage I and II breast cancer was explored and tested in a randomized trial to prove equivalence between BCT and mastectomy. The positive outcome led to trials in breast conserving therapy with lower doses and partial breast irradiation. Finally the need for finding genetic profiles for predicting treatment response will be addressed in a trial with preoperative partial breast irradiation.