Physics Bucharest 2017

Other solutions: IMRT?

Advantage  With IMRT - better

Considerations  Breast is a mobile organ (organ motion effects)  ACTIVE Breathing Control (ABC) costly apparatus required or voluntary breath hold (low tech)  Geometric uncertainties as per patients and lumpectomy cavity position  Uncertainties regarding surgical clips displacement / lumpectomy cavity

conformation of dose to target tissues, increased sparing of normal tissues , limiting dose to lungs & heart  Studies have shown – 50% reduction in cardiac mortality rate  % of ipsilateral lung volume receiving >20% of isocentre dose can be decreased to 3.4%

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