How do you approach breast hypofractionation RNI with the results of the Skagen Trial 1?

Do the results from the Skagen Trial 1, presented at ESTRO 2025, showing worse all-cause mortality and breast cancer-specific mortality in the hypofrac arm, warrant caution with using this approach, especially in light of the positive data from RT-CHARM?

2 Answers

Mednet MemberInvited Expert

Radiation Oncology · Varian Medical Systems/Allegheny health network

Answered on

There are multiple prospective/randomized studies showing non-inferiority for complications or cancer outcome with hypofractionation and RNI, including Wang et al., PMID 30711522, HypoG-01, FABREC, RT-CHARM, and the subset arm of STARTb. The primary endpoint of DKSG was also lymphedema, which was no...

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Radiation Oncology · Cape Oncology

Answered on

This is a great question. Was coverage of the internal mammary nodes suboptimal, perhaps due to perceived risk to the heart with the higher dose per fraction?

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