Topics:
Breast Cancer • Radiation Oncology
For a patient receiving postmastectomy IMRT to chest wall with expander and regional nodes including IMN, what constraint would you use for dose to the contralateral chest wall/implant if the patient also had a mastectomy and reconstruction on that side?
NSABP B-51 recommends V3<10% or a variation acceptable of V5<10% for contralateral breast. Is there a limit needed for contralateral chest wall/reconstructed chest dose?
Answer from: Radiation Oncologist at Community Practice
I use similar numbers and tend to accept a more generous approach to achieve coverage if the patient has undergone a contralateral mastectomy vs intact breast.
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Answer from: Radiation Oncologist at Community Practice
ALARA, basically. The dose must be distributed somewhere, and the more you avoid the contralateral chest wall, the higher the dose the ipsilateral lung and potentially the heart may receive.