Women with hormone positive, node negative, non-grade 3 and smaller breast cancers may choose to omit radiotherapy if they opt for endocrine therapy. Two large randomized controlled trials show that at 10 years, there were no survival differences, although local control was higher with radiotherapy ( 1% in RT + endocrine, versus 10% endocrine alone.)

Hence, omission of radiotherapy is possible in these patients

• limited life-expectancy from non-breast cancer pathology
• women who are taking endocrine therapy
• low-risk breast cancer

For women who are unable or not taking endocrine therapy, the risk of recurrence will be higher ( possibly more than 20%), and the role of radiotherapy is larger. Options for radiotherapy include

• Whole breast radiotherapy 5# in 1 week
• Partial breast radiotherapy 5# in 1 week, or 2 weeks ( depending on dose and radiotherapy techniques)