Is hypofractionation ever appropriate in women with early stage breast cancer and latent lupus who have never experienced skin symptoms in their lifetime?

Short answer: Yes. I do offer HFRT to such patients. No. I would not advise a "wait-and-see" approach. Long answer: There are actually two categories of considerations here:

First, are you comfortable treating patients with autoimmune/collagen vascular disease (CVD)? If so, are you a "lumper" or a ...