Can adjuvant treatment be optimized in low-risk breast cancer?

In Oncology, we increasingly looking for the personalization of breast cancer treatment under the premise of "less is more", there is currently a growing interest in identifying a subset of patients with early-stage breast cancer in whom the low risk of recurrence allows us to optimize adjuvant treatment. Radiotherapy in breast cancer has shown benefits at all stages and in all age groups, with minimal morbidity and excellent tolerance. Radiotherapy treatment has evolved, the volume of treatment has been reduced in low-risk subgroups (partial breast irradiation) and hypofractionated treatments, standard today, have demostrated disease control rates comparable to previous ones with a clear improvement in the quality of life of the patients. Endocrine therapy (ET) in breast cancer impacts local and distant recurrence, breast cancer-specific mortality and overall survival, but it associates significant side effects in the short, medium and long term and there are many women who have difficulty to tolerating this treatment. In this review, we try to answer questions such as: Is the omission of radiotherapy an option? And the omission of ET? In which patient profile can we consider optimizing adjuvant treatment? (C) 2023 SESPM. Published by Elsevier Espana, S.L.U. All rights reserved.