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Breast Cancer Research and Treatment

, Volume 96, Issue 1, pp 41–46 | Cite as

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
Report

Summary

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=8). 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.

Keywords

breast cancer contralateral breast dose intensity-modulated radiotherapy 

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Notes

Acknowledgement

We would like to posthumously thank Debbie Sonnik for her time and assistance in the preparation of this article.

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Copyright information

© Springer 2005

Authors and Affiliations

  • Ajay K. Bhatnagar
    • 1
  • Edward Brandner
    • 1
  • Deborah Sonnik
    • 1
  • Andrew Wu
    • 1
  • Shalom Kalnicki
    • 2
  • Melvin Deutsch
    • 1
  • Dwight E. Heron
    • 1
  1. 1.Department of Radiation OncologyUniversity of Pittsburgh Cancer InstitutePittsburghUSA
  2. 2.Department of Radiation OncologyEinstein-Montefiore Hospital, Montefiore Medical CenterBronxUSA

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