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Breast
Complex target
Internal mammary LN (IMN)
• If IMN is to be included in the treatment great care should be taken to minimise dose to
heart and lungs
• Usually ipsilateral IMN are treated
Solutions
1.
Extension of tangential fields
– by extending medial border – 3cm across midline or by
using imaging techniques
2.
Separate field –
•
Medial border
– midline , matching with tangential field border
•
Lateral border
– 5-6cm from midline
•
Superior border
– abuts inferior border of supraclav field or at 1
st
ICS (superior border
of head of clavicle) if only IMNs are to be treated
•
Inferior border
– at xiphoid or higher if 1
st
three ICS covered