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Peer-reviewedCC BY-NC-NDClinical and translational radiation oncology

The value of breast brachytherapy boost in the current era: a narrative literature review from the GEC-ESTRO breast cancer working group.

  • Irene Martínez Montesinos1,2
  • Katarzyna Konat-Bąska3,4
  • José-Luis Guinot5
  • Csaba Polgar6,7
  • Vratislav Strnad8
  • Jean-Michel Hannoun-Levi9
  • Cristina Gutierrez10,11
  • GEC-ESTRO Breast Cancer Working Group
11 affiliations
  1. 1Hospital Universitario de Navarra, Department of Radiation Oncology, Navarra, Spain.
  2. 2Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
  3. 3Wrocław Medical University, Faculty of Medicine, Department of Oncology, Wrocław, Poland.
  4. 4Radiotherapy Department, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.
  5. 5Fundación Instituto Valenciano de Oncología, Department of Radiation Oncology, Valencia, Spain.
  6. 6National Institute of Oncology, Center of Radiotherapy, Budapest, Hungary.
  7. 7Semmelweis University, Department of Radiotherapy, Budapest, Hungary.
  8. 8University Hospital Erlangen, Department of Radiation Oncology, Erlangen, Germany.
  9. 9Centre Antoine-Lacassagne, Department of Radiation Oncology, University Côte d'Azur, Nice, France.
  10. 10Institut Catalá d' Oncologia, Department of Radiation Oncology, Barcelona, Spain.
  11. 11Hospital del Mar, Department of Radiation Oncology, Barcelona, Spain.
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Abstract

Purpose

To identify patients who may benefit from an interstitial brachytherapy boost in the era of hypofractionation and widespread use of simultaneous integrated boost.Material and methods

Between 1984 and 2025, 112 articles were identified through a narrative search of the PubMed, MEDLINE, and Cochrane databases using the keywords "breast cancer", "boost", "interstitial brachytherapy", and "interventional radiotherapy". Two main areas were addressed: an update on risk factors and patient selection, and a review of boost techniques, with an emphasis on interstitial brachytherapy and comparisons with other techniques. Based on this evidence, we formulated recommendations on the role of brachytherapy boost in contemporary breast cancer (BC) treatment.Results

Based on the available literature, the addition of a boost should be strongly recommended for patients aged <40 years, patients with positive margins, and patients aged <50 years with at least one of the following features: high-grade disease, extensive intraductal carcinoma, and/or a triple-negative phenotype. In other scenarios, including residual disease after neoadjuvant chemotherapy, a balanced shared decision should be made. Interstitial brachytherapy allows delivery of a high radiation dose to the target volume while significantly reducing the dose received by adjacent organs at risk.Conclusion

The use of brachytherapy as a boost has declined, particularly since the introduction of integrated and ultra-hypofractionated regimens. In the current era of breast cancer treatment, we suggest that brachytherapy remains a valuable option for selected high-risk patients because it enables dose escalation tailored to the risk volume while sparing surrounding organs at risk.

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Cite

BibTeXRIS
BibTeX
@article{montesinos2026value,
  title = {{The value of breast brachytherapy boost in the current era: a narrative literature review from the GEC-ESTRO breast cancer working group.}},
  author = {Irene Martínez Montesinos and Katarzyna Konat-Bąska and José-Luis Guinot and Csaba Polgar and Vratislav Strnad and Jean-Michel Hannoun-Levi and Cristina Gutierrez and GEC-ESTRO Breast Cancer Working Group},
  journal = {Clinical and translational radiation oncology},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ctro.2026.101324},
  url = {https://europepmc.org/article/MED/42921130},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - The value of breast brachytherapy boost in the current era: a narrative literature review from the GEC-ESTRO breast cancer working group.
AU  - Irene Martínez Montesinos
AU  - Katarzyna Konat-Bąska
AU  - José-Luis Guinot
AU  - Csaba Polgar
AU  - Vratislav Strnad
AU  - Jean-Michel Hannoun-Levi
AU  - Cristina Gutierrez
AU  - GEC-ESTRO Breast Cancer Working Group
PY  - 2026
DA  - 2026/10/11
JO  - Clinical and translational radiation oncology
DO  - 10.1016/j.ctro.2026.101324
UR  - https://europepmc.org/article/MED/42921130
AB  - Purpose  To identify patients who may benefit from an interstitial brachytherapy boost in the era of hypofractionation and widespread use of simultaneous integrated boost.Material and methods  Between 1984 and 2025, 112 articles were identified through a narrative search of the PubMed, MEDLINE, and Cochrane databases using the keywords "breast cancer", "boost", "interstitial brachytherapy", and "interventional radiotherapy". Two main areas were addressed: an update on risk factors and patient selection, and a review of boost techniques, with an emphasis on interstitial brachytherapy and comparisons with other techniques. Based on this evidence, we formulated recommendations on the role of brachytherapy boost in contemporary breast cancer (BC) treatment.Results  Based on the available literature, the addition of a boost should be strongly recommended for patients aged <40 years, patients with positive margins, and patients aged <50 years with at least one of the following features: high-grade disease, extensive intraductal carcinoma, and/or a triple-negative phenotype. In other scenarios, including residual disease after neoadjuvant chemotherapy, a balanced shared decision should be made. Interstitial brachytherapy allows delivery of a high radiation dose to the target volume while significantly reducing the dose received by adjacent organs at risk.Conclusion  The use of brachytherapy as a boost has declined, particularly since the introduction of integrated and ultra-hypofractionated regimens. In the current era of breast cancer treatment, we suggest that brachytherapy remains a valuable option for selected high-risk patients because it enables dose escalation tailored to the risk volume while sparing surrounding organs at risk.
SN  - 2405-6308
ER  -