ASO Author Reflections: Preoperative Radiation Boost Reduces Re-Excision Rate and Locoregional Treatment Time in Early-Stage Breast Cancer Patients

A radiation tumor bed boost for breast cancer patients is typically delivered after breast-conserving surgery (BCS), either integrated with or sequentially after whole-breast radiation therapy (WBRT).This is based on convention and the limited historic data demonstrating poor wound healing after preoperative radiation. 1,2However, these studies focused on WBRT and not a radiation boost, which may offer advantages such as reduced locoregional treatment time due to operating room scheduling limitations and downsizing of the tumor prior to BCS, thus possibly resulting in lower rates of re-excision after initial lumpectomy.In the initial results of this phase II clinical trial, in which patients with early-stage breast cancer received a preoperative radiation boost, we showed that the rates of wound complications were non-inferior to the standard rates for patients receiving a postoperative boost. 3In this study, we aimed to show that the rate of re-excision after initial lumpectomy was lower, and the time from diagnostic biopsy to completion of radiation therapy was shorter, for patients in this trial receiving a preoperative radiation boost compared with patients at our institution receiving a standard postoperative radiation boost.