Original Investigation

Ablative Preoperative Single-Fraction Radiation Dose Escalation Among Patients With Breast Cancer

JAMA Network Open 10.1001/jamanetworkopen.2025.43689

November 14, 2025 at 11:00 AM EST

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Can single-fraction preoperative ablative stereotactic partial breast irradiation be safely delivered in doses of 30, 34, and 38 Gy in early-stage hormone receptor–positive breast cancer?In this phase 1 nonrandomized clinical trial with 44 patients, the maximum tolerated dose was not reached up to 38 Gy. High pathologic complete response rates combined with near complete response rates (up to 93.3%) were observed with prolonged time to surgery (>9 months).These findings suggest that stereotactic partial breast irradiation should be further investigated as a potential nonsurgical approach for selected early-stage hormone receptor–positive breast cancers.

Corresponding Author: Asal Rahimi, MD, MS, Department of Radiation Oncology, University of Texas Southwestern Medical Center, 2280 Inwood Rd, Dallas, TX 75390 (Asal.rahimi@utsouthwestern.edu).

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