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News
A 3-week radiation schedule after mastectomy works just as well as the traditional 5-week course for high-risk breast cancer patients, according to 10-year data from a phase III trial. Locoregional recurrence rates were comparable between the two approaches, with no meaningful differences in survival or severe late side effects. Experts say the findings further cement hypofractionated radiotherapy as a standard of care.
A shorter course of radiation after mastectomy continues to hold its own against the traditional longer regimen — even a decade out. Ten-year data from the CHN HYPOPMRT phase III trial, presented at the ASTRO 2026 Annual Meeting and published simultaneously in Lancet Oncology, show that hypofractionated postmastectomy radiotherapy (3 weeks) is noninferior to conventional fractionated radiotherapy (5 weeks) for patients with high-risk breast cancer. Locoregional recurrence rates were similar between groups, and there were no significant differences in disease-free or overall survival.
Safety-wise, severe late toxicity was rare in both arms. Grade 1–2 pulmonary fibrosis was slightly more common with hypofractionation, but no grade 4–5 events, brachial plexopathy, or treatment-related deaths occurred in either group. Experts note that inflammatory breast cancer patients — who may need dose escalation — remain an area requiring further study before hypofractionation is broadly adopted.
By the Numbers:
Why it matters: Hypofractionation cuts treatment time nearly in half — from 5 weeks to 3 — reducing the burden on patients and healthcare systems without sacrificing long-term outcomes. These durable 10-year results, backed by multiple trials, give clinicians strong evidence to make the shorter schedule the new standard for eligible high-risk breast cancer patients.
