The Evolving Role of Whole Breast Hypofractionation in Older Patients With Early Breast Cancer

Breast cancer in older patients presents an increasing health care challenge. Hypofractionated dose schedules of 15/16 daily fractions of postoperative radiotherapy over 3/3.5 weeks have been established in clinical trials with long term follow up as safe and effective and become the standard of care after breast conserving therapy for most older patients. Emerging clinical trial data are pushing the limits of hypofractionation to even shorter schedules over a week. In this mini-review the applicability of this new data to older patients is discussed and the development of guidelines for hypofractionated dose fractionation schedules adapted to the COVID19 pandemic for this age group.