Hypofractionated radiation therapy for early breast cancer and regional nodal irradiation—the jury is still out

A recent study on the shoulder-arm morbidity of the breast cancer UK START trials in axillary node positive women argues that hypofractionated lymph node radiation therapy is safe, as the long-term complications rates such as arm edema and shoulder stiffness remained low at 10-year follow-up (1). Can the authors’ conclusions apply to all patients with breast cancer who require lymph nodes irradiation after lumpectomy or mastectomy? Is hypofractionation really safe?