Do you ever use VMAT for breast cancer?

We do use it for RNI if can’t meet OAR constraints or when doing SIB boost.

Aim for V 20 < 25% for ipsilateral lung and mean heart dose of <2-3 Gy depending on the importance of covering IMN.

Certainly, coverage and conformity are better with VMAT. Low dose volume is larger with VMAT but prescription...

“Why is VMAT not considered the standard of care for locoregional radiation therapy for breast cancer patients?”

Kendall et al., Advances in Radiation Oncology 2025

This study tracks with my experience and makes a compelling case that it should be the standard of care.

• In most cases, it is superio...

For standard tangents, I do not use VMAT, and use field in field. For locally advanced breast cancer, I almost always use 3DCRT with rare use of IMRT for cases primarily where I am treating IM nodes and reconstruction is present and a 3DCRT plan cannot meet constraints. I have used VMAT in a few of ...

I consider IMRT/VMAT for complex RNI/PMRT cases when meeting constraints with 3D is challenging (when more comprehensive coverage is desired, unusual anatomy/chest shape). One disclaimer is that Mayo Clinic has proton therapy, which is a really nice solution for many complex/comprehensive plans (bil...