Emerging Promise of Preoperative Radiation in Hormone-Positive Breast Cancer

A study led by researchers at UT Southwestern Medical Center found that single-dose preoperative radiation produced a high rate of pathologic complete responses in an initial trial cohort.

The single-arm study enrolled 44 patients with early-stage, operable, hormone-receptor-positive breast cancer and delivered a single high, targeted dose of radiation (30, 34, or 38 Gy) before endocrine therapy and surgery.

Participants received endocrine therapy and proceeded to surgery after a median interval of about 9.8 months. A pathologic complete response was observed in roughly 72% of participants, with an additional 21% showing near-complete responses.

Unlike standard practice, where radiotherapy follows surgery over multiple fractions, this preoperative single-dose strategy compresses radiotherapy into one visit. That scheduling allows greater flexibility for surgical sequencing, can expand oncoplastic options, and reduces the irradiated tissue volume compared with whole-breast courses.