De-escalating locoregional radiation therapy in breast cancer: balancing promises and prudence
Early data suggest that RT de-escalation may be feasible for carefully selected patients, but current evidence does not justify unrestricted omission of RT in all pathological complete responders. Decisions should remain grounded in long-term outcomes, accurate pre-treatment staging, and robust validation of predictive biomarkers. Until such evidence matures, RT de-escalation should be undertaken cautiously - preferably within clinical trials or prospective registries and following multidisciplinary review - to minimize the risk of inadvertent locoregional undertreatment.
Authors
- Philip Poortmans (ORCID: https://orcid.org/0000-0001-7400-2293)
- Orit Kaidar‐Person (ORCID: https://orcid.org/0000-0003-4023-1869)
- Icro Meattini (ORCID: https://orcid.org/0000-0002-1861-2895)
- Gustavo Nader Marta (ORCID: https://orcid.org/0000-0002-3298-3684)
Institutions
- University of Antwerp (BE)
- Tel Aviv University (IL)
- Tel Aviv Sourasky Medical Center (IL)
- Sheba Medical Center (IL)
- Eastern Cooperative Oncology Group (US)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Iridium Kankernetwerk (BE)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
- Hospital Sírio-Libanês (BR)
- University of Florence (IT)
Publication Details
- Journal
- Expert Review of Anticancer Therapy
- Published
- 2025-12-14
- DOI
- https://doi.org/10.1080/14737140.2025.2604616
- Primary Topic
- Breast Cancer Treatment Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00