KEY POINTS
- This single-institution retrospective cohort included 94 women aged 65 years or older with ductal carcinoma in situ or early-stage invasive breast cancer treated after lumpectomy.
- All patients received adjuvant whole-breast irradiation to 28 Gy in 5 fractions, delivered twice per week using 3-dimensional conformal radiotherapy; 96.8% were treated prone.
- Median follow-up was 23 months; no grade 3 or higher acute or late radiation toxicities were reported.
- The most common acute grade 1–2 toxicities were fatigue (71%), dermatitis (53.3%), hyperpigmentation (29.9%), breast pain (29.3%), breast edema (24.4%), and pruritus (17.7%).
- At 1 year, physician-reported cosmesis was excellent or good in 98.8% of evaluable patients, with 1.2% fair and no poor cosmetic outcomes.
CLINICAL TAKEAWAY
Twice-weekly 28 Gy in 5 fractions appears feasible for selected older patients receiving whole-breast irradiation after breast-conserving surgery, with reassuring early toxicity and cosmesis in this cohort. The main caution is that this was a retrospective, single-institution study with missing toxicity data, short follow-up, small sample size, and a favorable older hormone receptor-positive population. This is worth attention as a practical scheduling approach, not a new standard regimen.