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Can the addition of posterior axillary boost (PAB) for breast cancer increase the risk of brachial plexopathy?

With conventional RT, the dose to the brachial plexus should be no more than 50-55Gy max. One exception to this is the addition of PAB in conventional technique, where a substantial hot spot (>60Gy sometimes) can develop in the anterior upper chest, depending on patient anatomy.
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

In the era of 3D volume based planning, it is important to contour the nodal regions and optimize coverage to the volume. In the 2D era, people use to prescribe to mid axilla and a PAB was commonly used. We know now that axillary nodes are far more anterior then that. To cover these nodes, we use an...

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