How do you define your treatment volumes when treating a patient with post-mastectomy radiation therapy?

Topics: Breast Cancer • Radiation Oncology

For instance, in a woman with small volume disease in the breast, is your posterior border still the lung interface? Do you cover all drain sites?

Answer from: Radiation Oncologist at Academic Institution

There are several ways to define treatment volume with PMRT. 1) The way that I have handled these cases is to wire out the chest wall and chest wall scar at sim and use this to create my treatment volumes rather than contouring. If the drain site is in the volume I cover it but otherwise dont exten...

Comments

Radiation Oncologist at Varian Medical Systems/Allegheny health network
The RTOG and ESTRO have conflicting guidelines. Th...

Radiation Oncologist at Ohio State University
Very nice review, thank you Dr Beriwal!

Answer from: Radiation Oncologist at Academic Institution

I agree with both answers from Drs Shah and Beriwal but offer the following observations : 1)The referenced Chang article makes it clear that patterns of local recurrence are quite different for breast conservation patients and post mastectomy patients. For the latter pectorals major must be ...

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