How soon should radiotherapy start post lumpectomy for breast cancer

The recommended time frame for initiating radiotherapy after a lumpectomy (breast-conserving surgery) in patients with breast cancer is typically within a few weeks following surgery, commonly starting radiotherapy 3 to 6 weeks postoperatively. This timing allows adequate wound healing while minimizing the risk of local recurrence.

Specifically, NICE guidelines recommend whole-breast radiotherapy to women with invasive breast cancer who have had breast-conserving surgery with clear margins, usually administered 5 days a week for 3 weeks after surgery.

Hypofractionated regimens such as 26 Gy in 5 fractions over 1 week or 40 Gy in 15 fractions over 3 weeks are now commonly offered, depending on patient factors and treatment specifics.

While the exact start time is not explicitly stated in the provided excerpts, the standard clinical practice and NICE guidance imply radiotherapy should commence soon after surgery once the patient has sufficiently recovered, generally within 3 to 6 weeks, to optimize local control and outcomes.

Delays beyond this period may increase the risk of local recurrence, so timely initiation is important.

Shared decision-making regarding radiotherapy timing and regimen should be undertaken with the patient.

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