Overview
Breast cancer is the most common female cancer globally, with metastatic disease risk increasing with tumor volume 1. Adenocarcinoma is the most frequent histological subtype.Diagnosis
Breast self-examination (BSE) is not recommended for the general population 1.
Clinical breast examination by practitioners is recommended from age 25 1.
Organized screening is recommended from age 50 to 74 1.Management
Adjuvant radiotherapy is essential after conservative surgery for infiltrating carcinoma to decrease local recurrence and specific mortality 2.
A boost dose to the tumor bed is recommended for patients younger than 50 years after conservative surgery 2.
Partial breast irradiation may be offered as an alternative to whole breast irradiation in selected, informed patients 2.
Adjuvant radiotherapy is systematically performed after lumpectomy for ductal carcinoma in situ 2.
Chest wall irradiation is required after mastectomy for pT3-T4 tumors or axillary nodal involvement 2.
Chest wall irradiation is recommended after neoadjuvant chemotherapy and mastectomy if there was clinically or radiologically T3-T4 or node-positive disease before chemotherapy, and pN0 disease 2.
Axillary irradiation is recommended if there is no axillary surgical dissection and a positive sentinel lymph node 2.
Supra- and infraclavicular irradiation is advised for positive axillary nodes 2.
Internal mammary irradiation should be discussed case-by-case due to potential cardiac toxicity 2.
Hypofractionation regimens are equivalent to conventional irradiation 2.Key Recommendations
BSE should not be recommended for women in the general population 1. (Evidence: Strong)
Adjuvant radiotherapy must be systematically performed after conservative surgery for infiltrating carcinoma 2. (Evidence: Strong)
After mastectomy, chest wall irradiation is required for pT3-T4 tumors and if there is axillary nodal involvement 2. (Evidence: Strong)References
1 Lavoue V, Favier A, Franck S, Boutet G, Azuar AS, Brousse S et al.. French college of gynecologists and obstetricians (CNGOF) recommendations for clinical practice: Place of breast self-examination in screening strategies. Breast (Edinburgh, Scotland) 2024. link
2 Hennequin C, Belkacémi Y, Bourgier C, Cowen D, Cutuli B, Fourquet A et al.. Radiotherapy of breast cancer. Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique 2022. link