Although early detection of breast cancer has increased over many decades, locally advanced breast cancers still occur, and they present a difficult clinical condition to manage. They often have significant associated symptoms, such as bleeding, pain and malodour, which can impact on quality of life. Unfortunately, there are often few curative options for their management.

We describe the case of a patient with a fungating breast cancer managed with high dose palliative radiotherapy, achieving good, durable local control and symptomatic relief. This case report highlights the effectiveness of a treatment often underutilised.