Radiotherapy as part of breast conserving therapy allows thousands of women annually to preserve their breasts and provides rates of cure that are equivalent to mastectomy. Significant Level 1 evidence provides support for optimization of local control with conventionally fractionated radiotherapy and meta-analyses demonstrate improvement in survival with this therapy. There is a major move to improve the convenience of BCT and options include selective omission of breast radiotherapy, hypofractionated whole breast radiotherapy or partial breast radiotherapy. A variety of techniques can be utilized for breast cancer therapy including conventional techniques, 3-D conformal techniques, IMRT, interstitial and balloon cather brachytherapy and intra-operative techniques. This session will provide comparative review of data on the variety of techniques both conventional and innovative. The speakers will provide comparative data on relative costs both direct and indirect associated with the current options in breast conservation. At the conclusion of this activity, the learner will be able to do the following: 1. Outline data from randomized prospective trials of breast conservation. 2. Discuss data on selective omission of breast radiotherapy. 3. Discuss costs relative to therapeutic options.