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The past decade has seen significant advances in the delivery of radiotherapy for breast cancer. This article presents an overview of the most recent advances in radiotherapy for early breast cancer with emphasis on English-language articles published since 1 July 2003.Breast radiotherapy is usually well tolerated. However, the uptake of radiotherapy in the management of breast cancer is less than ideal. Recent research efforts in radiation oncology have concentrated on addressing the uptake of appropriate radiotherapy by quantifying toxicity, further reducing toxicity, and improving the convenience of radiotherapy. Novel radiation techniques such as partial breast irradiation and shortened radiotherapy treatment courses are under development to make radiotherapy more acceptable to patients and referring clinicians. Issues such as the optimal timing of radiotherapy after surgery and integrating the radiation with newer adjuvant systemic therapies remain important research challenges.Radiotherapy remains an important component of breast cancer therapy. Improving the acceptance of treatment and minimizing toxicity and inconvenience of treatment should lead to even greater appropriate use.