Radiotherapy after neoadjuvant systemic treatment of breast cancer

When deciding on adjuvant radiotherapy in breast cancer patients, the decision is made based on the type of surgery (radical or conserving) and pathological report. In case systemic treatment is given before surgery, initial pathological report, which presents the backbone in decision making, is partly missing. Data from prospective randomized trials are lacking, and published retrospective data are inconsistent. Current guidelines are not clear for a large subset of patients. Also, guidelines and real-life data are often in discordance. This article aims to present literature data regarding the risk of locoregional relapse after neoadjuvant systemic treatment, the impact of radiotherapy on the risk of locoregional relapse, current clinical trial that is expected to give an answer in which subset of patients should adjuvant radiotherapy be performed and published clinical practice data.