Is active rheumatoid arthritis (RA) a contraindication to hypofractionated breast irradiation?

Active RA with some sort of skin manifestation may make me consider delaying/deferring RT, but it would not change what fractionation I use.

Here is recent data that shows no difference in toxicity across various fractionation schemes in patients with CVD.

I offer hypofractionated treatment to these patients. In review of the UK START data, the risk for breast shrinkage/normal tissue changes is lower with modest hypofractionation, suggesting that the lower overall dose may be beneficial.

I would usually review RA medications, discuss any medications t...

Hypofractionation showed less acute and chronic effects in comparison to conventional fractionation. So if there are no contraindications to RT, then hypofractionation is the preferred option.

It depends on how hypofractionated. I would be ok with a 4-week schedule but not 2 or 1 week. It also depends on the age and comorbidities of the patient and their logistical situation. Late complications or “effects” occur late. And “effects” sounds less unsettling. I follow patients I treated 20-3...