Fit older patients are candidates for WBI after breast conserving surgery for invasive cancer and for higher-risk DCIS
Whole Breast Irradiation (WBI) with a boost to the site of excision is appropriate for all older patients with invasive breast cancer; there is no specific subgroup from whom WBI can be systematically omitted.
Patients >50 are candidates for a hypofractionated schedule when lymph node irradiation is not indicated
Partial breast irradiation should still be considered investigational
3D based planning is advised to minimize lung/heart doses
Table 1: International Society of Geriatric Oncology (SIOG) recommedations for breast cancer radiation in the elderly.