DEGRO practical guidelines: radiotherapy of breast cancer-regional nodal irradiation

The aim of this work is to update the practical guidelines for adjuvant radiotherapy of the regional lymphatics in breast cancer, originally issued in 2014 by the Breast Cancer Expert Panel of the German Society of Radiation Oncology.

A comprehensive literature review concerning regional nodal irradiation (RNI) was performed using the search terms "breast cancer," "radiotherapy," and "regional node irradiation." Furthermore, data from recently published meta-analyses and international breast cancer society guidelines-providing new insights since 2014-served as the basis for defining evidence-based recommendations. This paper delineates the indications and dose-fractionation strategies for radiotherapy targeting the regional lymphatic pathways following breast cancer surgery.