Partial Accelerated Breast Irradiation The technical options for partial accelerated breast irradiation (APBI) are precise external irradiation, brachytherapy, hydrosalping catheter and intraoperative radiotherapy. The TARGIT-A study, which used intraoperative radiotherapy with X-rays, showed a 4-year local recurrence rate of 0.95% and 1.20% in the intraoperative radiotherapy and external irradiation groups, respectively. It will be interesting to see what the long-term results of this study will be. The American Society of Radiation Oncology (ASTRO) and European Society of Radiation Oncology (ESTRO) expert consensus on APBI is not entirely consistent, but it is useful in defining “low-risk” patients. Common requirements for the definition of “low-risk” patients include: single-centered lesions, invasive ductal carcinoma or other invasive carcinoma with good prognosis, no lymphovascular invasion or extensive intraductal component (EIC), negative margins (>2 mm), no neoadjuvant chemotherapy, unlimited tissue grade, excluding pure intraductal carcinoma, negative axillary lymph nodes, and allowing combination of lobular components. The combination of lobular carcinoma component is allowed. Whole-breast irradiation with “large segmentation” Whole-breast irradiation is also moving in the direction of “large segmentation”. The advantages of the large-split regimen in terms of shortening the treatment course, saving resources, and allowing more patients to receive breast-conserving treatment are obvious. However, it is also a double-edged sword, as it can increase the risk of normal tissue damage if not applied properly, such as uneven target areas, increased risk of fibrosis in the breast fold or axillary tail in high-dose areas, and increased long-term damage to the heart in the irradiated area. The completed relevant clinical phase III studies almost always select low-risk patients, and most of the target areas do not include lymphatic drainage areas.ASTRO expert consensus recommends T1-2N0 breast-conserving patients, age ≥ 50 years, without adjuvant chemotherapy, and in the central plane of the two-dimensional treatment plan dose drop does not exceed ± 7% feasible large split treatment. Tumor bed dose addition The results of the EORTCBoost study confirm that tumor bed addition reduces recurrence rates by approximately 50% in patients of all age groups. Therefore, Prof. Harris suggested that new studies related to macrodissection inevitably face the issue of bed-of-tumor dosing, and whether it should be concurrent or sequential with whole-breast irradiation remains a direction for future research. In addition, studies on the integration of lymphatic drainage area irradiation, including post-excision large-split radiotherapy, still need to be improved technically and have a longer follow-up period. Treatment after local recurrence Professor Vincini described the treatment strategy after local recurrence of breast cancer. The recurrence after breast-conserving surgery can be classified into 3 categories: 1) isolated recurrence without distant metastasis (60%); 2) recurrence with metastasis (10%); 3) recurrence with a significantly increased likelihood of metastasis (30%). 40% of patients can benefit from aggressive systemic therapy and 60% of patients need only local salvage therapy. The value of systemic therapy, especially chemotherapy, for patients with localized regional recurrence remains unclear. Isolated chest wall recurrences are subject to surgery combined with whole chest wall and supraclavicular radiotherapy to improve local control rates. Recurrence in patients who have received postoperative radiotherapy remains a challenge and requires an integrated treatment team to find an effective treatment strategy.