In the management of patients with locoregionally advanced breast cancer, the clinical mandate often shifts toward prioritizing local control, sometimes at the expense of long-term cosmesis. However, for survivors, the chronic sequelae of aggressive retreatment, particularly debilitating skin changes and fibrosis, can profoundly impact quality of life years after the final fraction is delivered. During the 2026 American College of Radiation Oncology (ACRO) Summit, CancerNetwork® sat down with J.