What is the maximum electron energy you would consider using for a breast lumpectomy boost?

I don’t go higher than 12 MeV (normalized typically to 80-85%) and usually am more in the 9 MeV range nowadays if using pure electrons. I have moved to doing most lumpectomy boosts with photons as we can be pretty conformal and more homogeneous (although sometimes we end up treating more breast tiss...

I typically limit electron energy to 16 MeV or less. Beyond that, I typically will incorporate photons (ex. mini tangents) or mixed (mini tangents with en face electron) depending on cavity.

Kannan et al., PMID 23006598.

Commonly use lateral decub to help with flattening of surface, make cavity superficial and improve dosimetry with less hot spots (use up to 16 MeV). Try to avoid photon if possible to decrease integral dose to breast.

If will use photon, favor multibeam technique to impr...