“…The dose to the skin and resulting desquamation was the limiting factor for the dose that could be delivered to the tumor. 10 The local control rates for gross disease with radiation were low, and late effects of radiation included necrosis, fibrosis, tissue atrophy, ulceration, fractures, lymphedema, and even a need for palliative mastectomy. 6,11 The 1950s saw the development of megavoltage radiation with the introduction of cobalt 60, the Van de Graaff unit, betatrons and synchrotrons, and the linear accelerator.…”