Are there situations in which hypofractionated breast RT is acceptable after neoadjuvant chemotherapy and lumpectomy?  

In my practice, I routinely offer hypofractionated whole breast radiation plus a boost (40 Gy/15 fractions plus 10-14 Gy in 5-7 fractions, as per START B) to any patient 40 and older who has received neoadjuvant chemotherapy and lumpectomy, provided my target is the breast only or breast plus low ax...

At our institution, we routinely do hypofractinated RT for women 50 and above after neoadjuvant chemo and BCS, as long as nodal region is not required to be treated. In the START B trial patients who had adjuvant chemo were included and had no difference in outcome.