Locoregional Therapies for Treatment of Invasive Breast Cancer: Review of Contemporary Clinical Trials

Purpose of Review: This review highlights contemporary clinical trials of locoregional therapies in the treatment of invasive breast cancer, focusing on pre-operative radiotherapy, omission of surgery, and omission of radiotherapy. Recent Findings: Emerging research has challenged the current standard of care regarding treatment sequences and evaluated the de-escalation of locoregional therapies. Pre-operative RT has garnered particular interest due to the ability to perform immediate reconstruction at the time of surgery. Likewise, for older patients with low-risk disease or those with exceptional response after neoadjuvant systemic therapy, omission of surgery and omission of radiotherapy, respectively, represent alternative treatment pathways that can both improve quality of life and decrease morbidity without compromising patient outcomes. Summary: Pre-operative radiotherapy, omission of surgery, and omission of radiotherapy represent contemporary issues with growing interest in the breast surgery community. Results from pivotal clinical trials will provide more concrete answers regarding feasibility and efficacy in the coming years.