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

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 extend...

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 include...