Evolutionary development of adjuvant radiotherapy for breast cancer. Part II. The role of radiotherapeutic techniques and technologies

With more than 2.3 million new cases and 685,000 deaths in 2020, breast cancer (BC) is the most commonly diagnosed cancer worldwide. The burden of BC is projected to rise to more than 3 million new cases and 1 million deaths in 2040.Radiotherapy in BC is an integrated and multifaceted approach to the special treatment of onco-mammary patients, with its role in reducing local recurrence of the disease already established. Radiotherapy not only controls the development of the tumor process, but also helps to reduce the size of the tumor focus, while causing minimal damage to adjacent normal tissues. Although radiotherapy predisposes, to some extent, to the development of a number of radiation side effects, it is considered one of the effective methods of special treatment for BC. Currently, there are many radiotherapy techniques used to treat BC. Each radiotherapy technique has its own limitations and treatment methods, which are implemented depending on the capabilities available in a given radiotherapy unit. Generally, radiotherapy for BC is performed after surgery and is aimed at reducing the risk of BC recurrence. Currently, based on technical advances in radiotherapy hardware, software and delivery systems, as well as computerized dosimetry planning and the development of new fractionation schemes, a consistent reduction in radiotherapy-related complications, such as pulmonary fibrosis and the development of long-term cardiac toxicity, has been achieved. This article briefly reviews issues related to current evolved techniques and methods of adjuvant radiotherapy aimed at improving the efficacy of special treatment for BC patients.