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A phase 3 trial shows that a shorter, 3-week course of radiation after mastectomy is just as safe and effective as the standard 5-week course for high-risk breast cancer patients. At 10 years, locoregional recurrence rates, survival outcomes, and severe side effects were all comparable between the two approaches. The findings, published in The Lancet Oncology, support wider adoption of hypofractionated radiotherapy to ease patient burden and improve access to care.
Less time under the beam, same long-term protection
A phase 3 trial presented at ASTRO 2026 and published simultaneously in The Lancet Oncology confirms that a shorter, 3-week course of radiation (hypofractionated postmastectomy radiotherapy) is noninferior to the traditional 5-week course for high-risk breast cancer patients — and the results hold up a full decade later. The study followed 810 women who had undergone mastectomy and required regional nodal irradiation, finding no meaningful differences in disease control or survival between the two regimens.
Importantly, no grade 4–5 toxicities, brachial plexopathy, or treatment-related deaths were observed in either group. The only notable difference was a slightly higher rate of mild (grade 1–2) pulmonary fibrosis in the shorter-course group — a manageable tradeoff. Experts caution that inflammatory breast cancer patients, who require higher radiation doses, should still receive conventional fractionation.
By the Numbers:
Why it matters: Cutting radiation treatment from 5 weeks to 3 weeks is a meaningful quality-of-life win for patients — fewer clinic visits, less time off work, and reduced financial strain. For healthcare systems, broader adoption could free up capacity and improve access to radiotherapy services globally.
