Do all patients of breast carcinoma need 3-dimensional CT-based planning? A dosimetric study comparing different breast sizes

Med Dosim. 2009 Summer;34(2):140-4. doi: 10.1016/j.meddos.2008.08.006. Epub 2008 Sep 24.

Abstract

Evaluation of dose distribution in a single plane (i.e., 2-dimensional [2D] planning) is simple and less resource-intensive than CT-based 3-dimensional radiotherapy (3DCRT) planning or intensity modulated radiotherapy (IMRT). The aim of the study was to determine if 2D planning could be an appropriate treatment in a subgroup of breast cancer patients based on their breast size. Twenty consecutive patients who underwent breast conservation were planned for radiotherapy. The patients were grouped in 3 different categories based on their respective chest wall separation (CWS) and the thickness of breast, as "small," "medium," and "large." Two more contours were taken at locations 5 cm superior and 5 cm inferior to the isocenter plane. Maximum dose recorded at specified points was compared in superior/inferior slices as compared to the central slice. The mean difference for small breast size was 1.93 (standard deviation [SD] = 1.08). For medium breas size, the mean difference was 2.98 (SD = 2.40). For the large breasts, the mean difference was 4.28 (SD = 2.69). Based on our dosimetric study, breast planning only on the single isocentric contour is an appropriate technique for patients with small breasts. However, for large- and medium-size breasts, CT-based planning and 3D planning have a definite role. These results can be especially useful for rationalizing treatment in busy oncology centers.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / radiotherapy*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Mammography / methods*
  • Organ Size
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Treatment Outcome