Evaluation of axillary dose coverage following whole breast radiotherapy: Variation with the breast volume and shape

Factors Influencing the Incidental Dose Distribution in Internal Mammary Nodes: A Comparative Study

“…Regardless of the radiotherapy technique, patient anatomy and clinical factors could eventually influence the dose distribution. Previous studies have associated body habitus with nodal volume dose distribution when breast cancer irradiation is administered (20,33). The results of these present study showed that obese or overweight patients had poorer dose coverage with fixed depth prescription than normal weight patients, and higher doses were associated with the more voluminous (≥1,200 cc) and pendulous breasts.…”

“…So far, several studies have evaluated axillary dose levels using different techniques, and found dose distribution was directly influenced by the breast volume and shape (18)(19)(20)(21). Active breathing control (ABC) technique can reduce the IMN coverage in left-sided breast cancer patients planned for postmastectomy radiation therapy (PMRT) (22).…”

Axillary Coverage by Whole Breast Irradiation in 1 to 2 Positive Sentinel Lymph Nodes in Breast Cancer Patients

“…Aguiar et al (20) recently retrospectively analyzed 100 patients treated and observed inadequate dose coverage to all axillary levels, even after applying a subanalysis accounting for different breast volumes and shapes. Although higher doses were associated with more voluminous and pendulous breasts, axillary coverage with 3D WBRT seems to be inefficient, regardless of the breast morphology.…”

Radiotherapy instead of axillary lymph node dissection: evaluation of axillary lymph node dose coverage with whole breast radiotherapy

“…Variability in contouring the targets between the institutions is substantial but level II volume shows lower variation. In our patients the mean value of level II volume was 13 cm 3 and in the studies using RTOG Atlas, the mean values were also under 20 cm 3 [16,17,20]. Nodal target volume definition in breast cancer radiotherapy using RTOG or ESTRO (European Society for Radiotherapy and Oncology) atlas has been debated [21,22].…”

“…In our patients, the mean dose of level II volume was somewhat higher: with HTgF or STgF 29 Gy and 7 Gy, respectively (p < 0.0001), but the geometric coverage of level II volume by HTgF was complete only in four patients. Aguiar et al [ 16 ] intended to treat only the breast and the mean doses of level I, II or III were 43.9 Gy, 38.6 Gy and 19. 5 Gy, respectively.…”