Is there any situation where hypofractionation of post-mastectomy radiation (CW and regional nodes) is absolutely contraindicated?

While not absolute given some phase 2 data, I am not currently offering hypofractionated PMRT to patients with reconstruction, as I am awaiting results of the Alliance trial.

I do offer hypofractionated PMRT to patients who are not undergoing reconstruction. However, I am cautious in patients with c...

Our standard is hypofractionation for PMRT but avoid/less likely to use in inflammatory breast cancer, in patients with undissected gross regional node or poor response to chemotherapy (the goal in these situations is to give higher total dose than 40 in 15 done by hypofractionation).

Defining where moderate hypofractionation is appropriate—and where caution applies—requires an integrated look at the randomized evidence. The trial by Wang et al. enrolled high-risk patients (pT3-4 and/or pN2-3) after mastectomy and axillary dissection and, at a median follow-up of 11.5 years, show...