The influence of lung density corrections on treatment planning for primary breast cancer

Dosimetric evaluation of whole breast radiotherapy using field-in-field technique in early-stage breast cancer

“…This dose inhomogeneity is related to the complex three-dimensional shape of the breast, with variations in distance between beam entry and exit points and in source-to-skin distances, and the effect of the lower attenuation of lung tissue included in the radiation field. In several studies, significant dose inhomogeneities up to 15-27% are demonstrated in the superior and inferior parts of the breast or the medial and lateral beam entries [2][3][4][5][6]. In addition, the medial and lateral aspects of the breast may also be exposed to higher doses of radiation due to lower attenuation of lung tissue in the treatment field [4,5].…”

“…In several studies, significant dose inhomogeneities up to 15-27% are demonstrated in the superior and inferior parts of the breast or the medial and lateral beam entries [2][3][4][5][6]. In addition, the medial and lateral aspects of the breast may also be exposed to higher doses of radiation due to lower attenuation of lung tissue in the treatment field [4,5]. These regions receiving increased doses have been shown to contribute to an inferior cosmetic result, breast pain, and significant variability in the total dose delivered to the resection site, particularly in large-breasted women [7][8][9][10][11].…”

Dosimetric evaluation of whole-breast radiation therapy: Clinical experience

“…3 Other researchers have investigated the use of IMRT and hybrid ("open" beams plus optimized beams) techniques for the treatment of breast cancer. [12][13][14][15][16][17][18][19][22][23][24][25][26][27][28] The hybrid treatment planning uses "open" and optimized beams to produce a homogeneous dose distribution, and to decrease the effect of respiratory motion, the "open" beams are usually assigned weights that are as high as possible, and the tangential posterior field edges are matched to spare lung dose. 20,21 There is a lack of consistency among institutions or individuals on what is considered an acceptable treatment plan: target coverage vis-à-vis dose to OAR.…”

Dosimetric comparison of intensity modulated radiotherapy techniques and standard wedged tangents for whole breast radiotherapy*

“…4 The dose distribution of SWT worsens with increasing breast size, and variations as large as 15-20% have been reported in several studies. 5,6 This may also be particularly exaggerated when hypofractionated regimens are utilized.…”