The present study prospectively reported both physicians’ and patients’ assessment for toxicities, cosmetic assessment and patients’ satisfaction after 3D-conformal accelerated partial breast irradiation (APBI).From October 2007 to September 2009, 30 early breast cancer patients were enrolled in a 3D-conformal APBI Phase II trial (40Gy/10 fractions/5days). Treatment related toxicities and cosmetic results were assessed by both patients and physicians at each visit (at 1, 2, 6months, and then every 6months). Patient satisfaction was also scored.After a median follow-up of 27.7months, all patients were satisfied with APBI treatment, regardless of cosmetic results or late adverse events. Good/excellent cosmetic results were noticed by 80% of patients versus 92% of cases by radiation oncologists. Breast pain was systematically underestimated by physicians (8–20% vs. 16.6–26.2%; Kappa coefficient KC=0.16–0.44). Grade 1 and 2 fibrosis and/or breast retraction occurred in 7–12% of patients and were overestimated by patients (KC=0.14–0.27).Present results have shown discrepancies between patient and physician assessments. In addition to the assessment of efficacy and toxicity after 3D-conformal APBI, patients’ cosmetic results consideration and satisfaction should be also evaluated.