Adjuvant partial breast irradiation (PBI) has been shown to result in better cosmesis than whole breast irradiation
however, in the post-oncoplastic breast surgery (OPBS) setting its use remains controversial due to uncertainty over patient selection and accurate tumor bed identification. Our objective is to define the problem of combining PBI and OPBS, identify which oncoplastic patients may be potential candidates for PBI, and hypothesize how we may be able to combine the two techniques for select cases. A comprehensive literature search was conducted on the principles and clinical applications of PBI and OPBS in the context of breast cancer treatment. While PBI is not strongly recommended for most OPBS patients, it may be feasible in those who undergo a limited volume displacement where tumor bed and adjacent at-risk breast tissue is left intact and can be appropriately identified and targeted. Prospective studies are needed to investigate the feasibility of PBI after OPBS. Multidisciplinary collaboration between plastic and reconstructive surgeons and radiation oncologists in both the pre- and post-operative setting is essential for oncoplastic surgical planning and to ensure appropriate delineation of the tumor bed for PBI planning.