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Breast Cancer Reirradiation Practice Patterns: An International Survey From the Reirradiation Collaborative Group
Linda Hong1, Philip Poortmans2, Marianne Aznar3
1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York.
Practical Radiation Oncology
|May 28, 2026
Summary
Reirradiation for recurrent breast cancer shows varied practices globally. Key knowledge gaps include long-term outcomes, standardized dose guidance, and optimal fractionation, necessitating clinical guidelines for better patient care.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Reirradiation (reRT) for recurrent breast cancer is an evolving treatment modality.
- Current practice patterns for reRT in breast cancer are heterogeneous.
- The Reirradiation Collaborative Group (ReCOG) aimed to assess current reRT practices and identify knowledge gaps.
Purpose of the Study:
- To evaluate contemporary clinical reirradiation practices for locally or regionally recurrent breast cancer.
- To identify key knowledge gaps influencing optimal breast reirradiation approaches.
- To understand factors influencing patient selection and treatment planning for reirradiation.
Main Methods:
- A structured survey was administered to radiation oncologists, medical physicists, and dosimetrists internationally.
- The survey collected data on patient selection criteria, treatment modalities, dose-fractionation schedules, and planning techniques.
- Respondents reported on factors influencing treatment decisions and identified knowledge gaps.
Main Results:
- Thirty-seven international experts participated, revealing significant heterogeneity in reRT practices.
- Common reasons for not offering reRT included high risk of side effects and short relapse intervals.
- Fibrosis, pain, and lymphedema were the most impactful toxicities; conventional fractionation was most common, with varied OOI dose guidance.
Conclusions:
- Breast cancer reirradiation practices are highly heterogeneous internationally.
- Significant knowledge gaps exist regarding long-term outcomes, standardized dose guidance, and optimal fractionation.
- Standardized guidelines and clinical tools are needed to improve decision-making and outcomes in breast reirradiation.
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