Palliative radiotherapy in the breast and chest wall

The primary goal of palliative radiation for locally advanced or unresectable disease of the breast is to provide relief from unpleasant or distressing symptoms. Other goals are durable local control and improved patient quality of life. There may be a positive influence on the course of the overall disease, but whether there is an improvement in survival in the patient responding to systemic therapy or with limited metastatic disease is unknown. Palliative radiation needs to offer its clinical benefit with a minimum of treatment-related inconvenience or side effects so is most often given with hypofractionation and avoidance of elective volumes. This chapter will discuss the indications, goals, dose, and outcomes for palliative radiation for cancers of the breast, chest wall, and skin region.