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International Journal of Breast Cancer
Volume 2018, Article ID 1402824, 4 pages
Review Article

Postmastectomy Radiation Therapy: Are We Ready to Individualize Radiation?

1Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
2Hazelrig Salter Radiation Oncology Center, 1700 6th Ave South, Birmingham, AL 35249, USA
3The Kirklin Clinic at Acton Road, 2145 Bonner Way, Birmingham, AL 35243, USA

Correspondence should be addressed to Jennifer F. De Los Santos; ude.cmbau@sotnassoledj

Received 22 November 2017; Revised 12 January 2018; Accepted 15 January 2018; Published 1 March 2018

Academic Editor: Robert-Alain Toillon

Copyright © 2018 Ashlyn S. Everett et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Contemporary recommendations for postmastectomy radiation have undergone a shift in thinking away from simple stage based recommendations (one size fits all) to a system that considers both tumor biology and host factors. While surgical staging has traditionally dictated indications for postmastectomy radiation therapy (PMRT), our current understanding of tumor biology, host, immunoprofiles, and tumor microenvironment may direct a more personalized approach to radiation. Understanding the interaction of these variables may permit individualization of adjuvant therapy aimed at appropriate escalation and deescalation, including recommendations for PMRT. This article summarizes the current data regarding tumor and host molecular biomarkers in vitro and in vivo that support the individualization of PMRT and discusses open questions that may alter the future of breast cancer treatment.