Are there situations where you would use hypofractionated radiotherapy for Stage III breast cancer?

The answer to this question is complex, and cannot be adequately explained in a brief response.

Treatment of local advanced breast with hypofractionated radiation is not currently an accepted standard practice in this country. This situation occurs in both breast conservation and mastectomy (+/- reconstruction) patients in which patients require radiation to their regional lymph nodes. Given the results of MA.20 and EORTC 22922, the number of patients who will be treated to the regional lymphatic...

I agree with @Dr. First Last and appreciate his clear and concise review of the literature. In our practice, the only (non-inflammatory) patients for whom we do not offer hypofractionation are those with immediate tissue-expander-based reconstruction. Given the dearth of evidence for such cases, and that the plastic surgeon is going to blame you for any and all complications that occur, it's best to steer clear of anything fancy here. If a woman is willing to go through all of the rigmarole of t...

We routinely offer HFRT for PMRT for non inflammatory breast cancer or for patients without immediate reconstruction (we offer them the NRG study). We use 40 Gy in 15 fractions.