[Comment] Hypofractionated nodal radiotherapy in breast cancer: time for an updated standard of care?

Minimising the effect of arm swelling (lymphoedema) caused by breast cancer treatment is a key goal for patients and health-care providers, given the potential detrimental effect on physical, psychological, and social wellbeing. Historically, breast axillary nodal radiotherapy was associated with major harm to patients in the 1970s and 1980s, resulting in lymphoedema and nerve damage (brachial plexopathy), which caused severe pain and loss of arm function. The causes were multifactorial, including large radiation doses, overlapping radiotherapy fields, and poor-quality radiotherapy with an absence of standardised protocols and quality assurance.