When offering palliative radiation for breast cancer, what dose/fractionation do you prefer and in what subset of patients do you believe derive the most benefit?   

More recently after FAST-Forward, use 26 Gy in 5 for palliation as shorter and reasonable dose to palliate pain, bleeding, and drainage.

This is the only prospective study in this setting showing short course can achieve significant palliative and well-tolerated Chatterjee et al., PMID 36868522 

GRID radiation is how I treated my most recent case of neglected/ulcerated breast tumor, and I'm really pleased with the result. We used a single oblique beam of 10X energy to deliver 15 Gy x1 of GRID using MLC shaping, with a pattern of 1 cm open per 3 cm closed. It was an almost identica...

There is randomized data supporting no difference in survival or QOL with locoregional palliation across the board in breast cancer, so I do not offer it to all patients. I select patients using the same principles for general palliation - pain, bleeding, functional limitations, etc. I generally do ...

It depends on what you are trying to palliate. If the patient is having significant bleeding and the goal is to control the bleeding in a patient that is potentially curable, I use 8 Gy in a single fraction using electrons and just treat the superficial aspect of the tumor. This can be repeated if n...