The place of radiotherapy in the treatment of inflammatory breast cancer: Practical questions and responses.

Inflammatory breast cancer represents a rare and aggressive form of locally advanced breast cancer with distinct biological characteristics requiring specialized treatment approaches. Despite its clinical importance, standardized radiotherapy guidelines for inflammatory breast cancer management remain limited, and these patients are often underrepresented in clinical trials. This review aims to provide some practical radiotherapy recommendations for inflammatory breast cancer by integrating data from prospective clinical trials, population studies, and emerging genomic insights. The purpose is to establish clear therapeutic strategies that distinguish between chemosensitive and chemorefractory tumours, optimize dose fractionation and target volume definition, and provide guidance on combination with systemic therapies. These recommendations seek to improve clinical outcomes while avoiding inappropriate therapeutic de-escalation in this high-risk population requiring multidisciplinary expert discussions.