Local regional control, despite its lack of impact on survival, continues to be recognized as an important end point in and of itself. In addition to recent updates on conservation studies demonstrating this dichotomy, local regional radiation is now playing an important role in the management of advanced breast cancer postmastectomy. The most extreme example of this importance is its inclusion in autologous bone marrow transplantation programs. Documentation of the long-term outcome of breast or chest wall radiation, in terms of both complications and treatment failures, appears increasingly in this year's literature. With sophisticated biostatistical analysis of all factors predicting for both local failure and late complications, patient selection for these treatments should become easier for both the woman and her physician.