Is the skin dose adequate when treating a patient prone for breast cancer?

Good Question! This is how you can approach the issue in any patient position:

The skin is not a target in whole breast radiation planning. When contouring breast tissue, typically 5 mm from skin surface is eliminated/deleted when creating this structure. Plan your whole breast treatment after creating a lumpectomy-bed-PTV structure in addition to the whole breast, even if not planning to boost. Then, when evaluating your DVHs of any whole breast plan, you can ensure that coverage to the PTV-lumpectomybed is adequate. For me, it is most important to have PTV_lumpectomybed coverage (whether you use 95/95 or 100/95) than the whole breast. This is your highest risk area. For lateralized lumpectomy beds, it is often necessary to use 6mvx photon...