Small Fields, Big Decisions: The Evolving Role of Partial Breast Irradiation

Partial breast irradiation (PBI) has emerged as an increasingly important treatment option for appropriately selected patients with early-stage breast cancer, offering a more targeted approach to radiation therapy while reducing treatment burden and minimizing exposure to surrounding normal tissues. With updated ASTRO clinical practice guidelines, maturing randomized trial data, and advances in radiation delivery techniques, the role of PBI continues to expand in contemporary breast cancer management.

This activity reviews the evolving evidence supporting PBI, highlighting key clinical trials, expanded patient selection criteria, modern treatment techniques, and dose-fractionation schedules. Particular emphasis is placed on practical challenges and ongoing controversies, including PBI in younger patients, invasive lobular carcinoma, and patients undergoing oncoplastic breast surgery. Faculty discuss treatment planning considerations, technique, tumor-bed localization, cosmetic outcomes, and strategies to optimize the balance between oncologic safety and treatment-related toxicity.

Through evidence-based discussion and clinically relevant scenarios, participants will gain practical insights into integrating PBI into routine practice, navigating challenging treatment decisions, and advancing individualized, patient-centered breast cancer care.

The content was originally presented and recorded as a live webinar on November 10, 2026.

This activity will be available from November 16, 2026 to November 15, 2028.

Target Audience

The activity is designed to meet the interests of  radiation oncologists and radiation oncology residents

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Participants should be able to correctly determine PBI eligibility and justify their treatment recommendations using guideline-based criteria in a clinical case scenario.
  • Participants should be able to select and justify an appropriate PBI technique and fractionation schedule for a clinical case, incorporating patient-specific factors, treatment-planning considerations, and expected clinical outcomes.

 

Course summary

Available credit: 
  • 0.75 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 0.75 Certificate of Attendance
    This activity was designated for 0.75 AMA PRA Category 1 Credit™.
Course opens: 
11/16/2026
Course expires: 
11/15/2028
Cost:
$149.00
Rating: 
0

Moderator:

  • Parul Barry, MD, is employed by the University of Pittsburgh Medical Center. Dr. Barry has no relevant financial relationship with ineligible companies. 

Speaker:

  • Tiarrah Salvi-Jackson, MD, is employed by Duke Cancer Institute. Dr. Salvi-Jackson has no relevant financial relationship with ineligible companies.

Planner:

  • Parul Barry, MD, is employed by the University of Pittsburgh Medical Center. Dr. Barry has no relevant financial relationship with ineligible companies. 

Reviewer:

  • Michael Haddock, MD, is employed by Mayo Clinic and has no relevant financial relationship with ineligible companies to disclose.

All relevant financial relationships have been mitigated.

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Available Credit

  • 0.75 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 0.75 Certificate of Attendance
    This activity was designated for 0.75 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
Please login or register to take this course.

Activity Fees

This activity is included in the ASTRO Academy Subscription. To purchase the subscription beginning December 1, 2026, please go to the ASTRO Product Catalog.

ASTRO members and Academy subscribers must log in to the ASTRO Academy to view and receive the corresponding rate:

  • Academy Subscriber: $0
  • Member: $99
  • Member-in-Training / Student Member / Postdoctoral Fellow Member: $49
  • Nonmember: $149

Discounts
Please email ASTRO eLearning to inquire about the discounts below.

  • If you are an ASTRO member residing in a low- or lower-middle-income economy country, as identified by the World Bank, you can receive a 50% discount off the activity fee.
  • If you are an ASTRO member residing in an upper-middle-income economy country, as identified by the World Bank, you can receive a 25% discount off the activity fee.

Policies

No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date.

Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.

The activity and its materials will only be available on the ASTRO website until the Activity expiration date, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.

Copyright of all aspects of ASTRO Academy Content, including recordings and/or reproductions of sessions, programs, presentations, discussions and other scheduled events (“ASTRO Academy Content”) is owned by ASTRO. Only ASTRO reserves the rights to all ASTRO Academy Content, including to digitize, modify, alter, edit, adapt, create derivative works, display, publicly perform, exhibit, transmit, broadcast, reproduce, exploit, sell, rent license, otherwise use, and permit others to use, such ASTRO Academy Content. Photographing, filming, taping, recording or any form of capture or reproduction in any medium of any aspect of ASTRO Academy Content, including, but not limited to the programs, presentations, material, sessions, and discussions, or on the Academy platform are strictly forbidden without written authorization from ASTRO.

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.