Physics Bucharest 2017

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