Risk factors for breast fibrosis and unfavorable cosmetic outcomes after breast conserving therapy in the contemporary treatment era: a systematic review

The risk factors identified in this review are largely similar to those found in 2D-radiotherapy studies; dose homogeneity was additionally identified. Administering chemotherapy before radiotherapy should be considered for patients requiring both treatments. However, the lack of sufficient high-quality data regarding BCT with (complex) oncoplastic surgery techniques and ultra-hypo fractionated radiotherapy schedules address the need for large, multidisciplinary prospective studies with long-term follow-up.