The current status of primary radiation therapy in the treatment of early breast cancer.

Primary radiation therapy, usually with limited surgery, is being used increasingly as an alternative to mastectomy in patients with early breast cancer. Results so far appear similar in terms of local control and overall survival. Current questions on patient selection, extent of surgery, radiation therapy technique, possible long-term complications, and the role of axillary dissection and of adjuvant therapy are reviewed. Though many questions remain, it is hoped that this alternative will contribute to improved survival along with breast preservation for improved quality of life.