Radiotherapy for breast cancer in BRCA1/BRCA2 carriers: clinical issues and management dilemmas.

Although radiotherapy is an integral part of the treatment of breast cancer, its role for patients who are carriers of BRCA1 or BRCA2 mutations has been questioned. This article reviews the data regarding radiation-associated complications in BRCA1/BRCA2 carriers, then compares the outcomes following breast-conserving surgery and radiotherapy in breast cancer patients with germline mutations and those with sporadic disease. Risk reduction strategies that could impact both ipsilateral and contralateral breast events are presented. The significant reduction in the incidence of breast cancer following bilateral prophylactic mastectomy is also discussed, as well as the potential for adverse psychological sequelae.