Commentary on the GEC-ESTRO trial: is partial breast irradiation ready for prime time?

In the era of personalized oncology, a multidisciplinary approach has been utilized involving surgery, radiation, and systemic therapy in the management of patients with breast cancer. Recent advances in adjuvant systemic therapy have reduced the risk of distant metastases and local recurrences as well; improvements in imaging technology and radiation therapy have also contributed to the same. Given these factors, a “less is more” approach has been gradually accepted in surgical oncology. In patients with early stage of breast cancer, breast-conserving therapy (BCT) is suggested instead of mastectomy. BCT has proved the “less is more” concept because compared with mastectomy patients undergoing BCT have shown a higher survival rate (1).
BCT comprises breast-conserving surgery (BCS) with adjuvant radiation therapy and axillary management. A less-invasive procedure has been attempted for each element. In axillary management, the safe omission of axillary clearance can be extended from patients with a negative sentinel-node to being positive for metastasis (2,3).