Uptodate.

Here is an excellent summary of where we stand with breast radiation going into 2022. Yet again, it highlights the appropriate option of 5-fraction whole or partial breast irradiation for women who do not merit regional nodal irradiation (RNI). For RNI, hypofractionation is appropriate for women after mastectomy without reconstruction and is being evaluated for those with reconstructed and conserved breasts. This may all be more interesting to the folks getting bundled payments within the RO-APM come January. Other potential paradigm shifts in the pipeline include the use of Oncotype to inform the benefit of RNI or of any breast radiation and a shift towards radiation versus endocrine monotherapy for low-risk patients, largely thanks to advancements in the ease of treatment per above. | Shah, JCO Oncol Pract 2021