Intensity modulated radiation therapy (IMRT) reduces the dose to the contralateral breast when compared to conventional tangential fields for primary breast irradiation

Ajay K. Bhatnagar, Edward Brandner, Deborah Sonnik, Andrew Wu, Shalom Kalnicki, Melvin Deutsch, Dwight E. Heron

Research output: Contribution to journalArticle

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Abstract

Purpose. To determine the dose received by the contralateral breast during primary breast irradiation using IMRT compared to conventional tangential field techniques. Methods and materials. Between March 2003 and March 2004, 83 patients with breast carcinoma were treated using 6, 10, or mixed 6/18 MV photons (65 with tangential IMRT technique and 18 with 3-dimensional technique using tangential fields with wedges) for primary breast irradiation following breast-conserving surgery. Paired thermoluminescent dosimeters (TLDs) were placed on each patient's contralateral breast, 4 and 8 cm from the center of the medial border of the tangential field. The TLDs were left on the patient during a single fraction and then measured 24 h afterwards. Results. The mean dose delivered with photons to the primary breast for all patients was 4999 cGy (SD = 52) with a mean single fraction dose of 199 cGy (SD = S). The mean percent of the prescribed dose to the contralateral breast measured at the 4- and 8-cm positions were 7.19% (SD = 2.28) and 4.63% (SD = 2.12), respectively, for patients treated with IMRT compared to 11.22% (SD = 2.73) and 10.70% (SD = 3.44), respectively, for the patients treated with conventional tangential field techniques. This represented a 36% and 57% reduction at the 4 and 8-cm contralateral positions, respectively, in the mean dose to the contralateral breast using IMRT compared to 3-D technique which was statistically significant (p <0.0005, < 0.0005, respectively). Conclusion. Primary breast irradiation with tangential IMRT technique significantly reduces the dose to the contralateral breast compared to conventional tangential field techniques.

Original languageEnglish (US)
Pages (from-to)41-46
Number of pages6
JournalBreast Cancer Research and Treatment
Volume96
Issue number1
DOIs
StatePublished - Mar 2006

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Breast
Radiotherapy
Photons
Segmental Mastectomy
Breast Neoplasms

Keywords

  • Breast cancer
  • Contralateral breast dose
  • Intensity-modulated radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Intensity modulated radiation therapy (IMRT) reduces the dose to the contralateral breast when compared to conventional tangential fields for primary breast irradiation. / Bhatnagar, Ajay K.; Brandner, Edward; Sonnik, Deborah; Wu, Andrew; Kalnicki, Shalom; Deutsch, Melvin; Heron, Dwight E.

In: Breast Cancer Research and Treatment, Vol. 96, No. 1, 03.2006, p. 41-46.

Research output: Contribution to journalArticle

Bhatnagar, Ajay K. ; Brandner, Edward ; Sonnik, Deborah ; Wu, Andrew ; Kalnicki, Shalom ; Deutsch, Melvin ; Heron, Dwight E. / Intensity modulated radiation therapy (IMRT) reduces the dose to the contralateral breast when compared to conventional tangential fields for primary breast irradiation. In: Breast Cancer Research and Treatment. 2006 ; Vol. 96, No. 1. pp. 41-46.
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abstract = "Purpose. To determine the dose received by the contralateral breast during primary breast irradiation using IMRT compared to conventional tangential field techniques. Methods and materials. Between March 2003 and March 2004, 83 patients with breast carcinoma were treated using 6, 10, or mixed 6/18 MV photons (65 with tangential IMRT technique and 18 with 3-dimensional technique using tangential fields with wedges) for primary breast irradiation following breast-conserving surgery. Paired thermoluminescent dosimeters (TLDs) were placed on each patient's contralateral breast, 4 and 8 cm from the center of the medial border of the tangential field. The TLDs were left on the patient during a single fraction and then measured 24 h afterwards. Results. The mean dose delivered with photons to the primary breast for all patients was 4999 cGy (SD = 52) with a mean single fraction dose of 199 cGy (SD = S). The mean percent of the prescribed dose to the contralateral breast measured at the 4- and 8-cm positions were 7.19{\%} (SD = 2.28) and 4.63{\%} (SD = 2.12), respectively, for patients treated with IMRT compared to 11.22{\%} (SD = 2.73) and 10.70{\%} (SD = 3.44), respectively, for the patients treated with conventional tangential field techniques. This represented a 36{\%} and 57{\%} reduction at the 4 and 8-cm contralateral positions, respectively, in the mean dose to the contralateral breast using IMRT compared to 3-D technique which was statistically significant (p <0.0005, < 0.0005, respectively). Conclusion. Primary breast irradiation with tangential IMRT technique significantly reduces the dose to the contralateral breast compared to conventional tangential field techniques.",
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N2 - Purpose. To determine the dose received by the contralateral breast during primary breast irradiation using IMRT compared to conventional tangential field techniques. Methods and materials. Between March 2003 and March 2004, 83 patients with breast carcinoma were treated using 6, 10, or mixed 6/18 MV photons (65 with tangential IMRT technique and 18 with 3-dimensional technique using tangential fields with wedges) for primary breast irradiation following breast-conserving surgery. Paired thermoluminescent dosimeters (TLDs) were placed on each patient's contralateral breast, 4 and 8 cm from the center of the medial border of the tangential field. The TLDs were left on the patient during a single fraction and then measured 24 h afterwards. Results. The mean dose delivered with photons to the primary breast for all patients was 4999 cGy (SD = 52) with a mean single fraction dose of 199 cGy (SD = S). The mean percent of the prescribed dose to the contralateral breast measured at the 4- and 8-cm positions were 7.19% (SD = 2.28) and 4.63% (SD = 2.12), respectively, for patients treated with IMRT compared to 11.22% (SD = 2.73) and 10.70% (SD = 3.44), respectively, for the patients treated with conventional tangential field techniques. This represented a 36% and 57% reduction at the 4 and 8-cm contralateral positions, respectively, in the mean dose to the contralateral breast using IMRT compared to 3-D technique which was statistically significant (p <0.0005, < 0.0005, respectively). Conclusion. Primary breast irradiation with tangential IMRT technique significantly reduces the dose to the contralateral breast compared to conventional tangential field techniques.

AB - Purpose. To determine the dose received by the contralateral breast during primary breast irradiation using IMRT compared to conventional tangential field techniques. Methods and materials. Between March 2003 and March 2004, 83 patients with breast carcinoma were treated using 6, 10, or mixed 6/18 MV photons (65 with tangential IMRT technique and 18 with 3-dimensional technique using tangential fields with wedges) for primary breast irradiation following breast-conserving surgery. Paired thermoluminescent dosimeters (TLDs) were placed on each patient's contralateral breast, 4 and 8 cm from the center of the medial border of the tangential field. The TLDs were left on the patient during a single fraction and then measured 24 h afterwards. Results. The mean dose delivered with photons to the primary breast for all patients was 4999 cGy (SD = 52) with a mean single fraction dose of 199 cGy (SD = S). The mean percent of the prescribed dose to the contralateral breast measured at the 4- and 8-cm positions were 7.19% (SD = 2.28) and 4.63% (SD = 2.12), respectively, for patients treated with IMRT compared to 11.22% (SD = 2.73) and 10.70% (SD = 3.44), respectively, for the patients treated with conventional tangential field techniques. This represented a 36% and 57% reduction at the 4 and 8-cm contralateral positions, respectively, in the mean dose to the contralateral breast using IMRT compared to 3-D technique which was statistically significant (p <0.0005, < 0.0005, respectively). Conclusion. Primary breast irradiation with tangential IMRT technique significantly reduces the dose to the contralateral breast compared to conventional tangential field techniques.

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