[Adjuvant radiotherapy of breast carcinoma]

Adjuvant postoperative radiotherapy for breast conserving treatment is well established. Contraindications against breast conservation are macroscopic tumor residues, multicentric disease, diffuse microcalcifications or inflammatory carcinoma because of the necessary radiation (dose) which exceeds the tolerance of the breast. Treatment results are comparable for skillful excision and quadrantectomy or segmentectomy. The impact of postoperative radiotherapy is debated for very favourable situations--clinical evidence of significant prognostic factors is the aim of prospective randomized studies. Postoperative radiotherapy after mastectomy diminishes five fold the local recurrence rate. This strategy does improve the quality of life. Prognostic factors for local relapse are T3-, T4-tumors, extensive axillary involvement, multifocal or multicentric disease, extensive lymphangiosis and extensive intraductal carcinoma. New clinical protocols confirm the value of radiotherapy of the regional lymph nodes. The results show a promising impact not only on the regional but also on the distant relapse free time and the overall survival.