Presented by Tan Chek Wee, MSc, BSc, Dip, CMD
National University Cancer Institute

Breast cancer is the most common cancer in women. In 2020, there were about 2.3 million women diagnosed with breast cancer globally according to World Health Organization (WHO). Radiotherapy of the breast or chest wall is traditionally delivered using tangential fields e.g.with wedges or field-in-field (FinF) technique. In the traditional field treatment, the tangential fields are extended largely outside the skin contour to take into account breathing motion and deformations of the soft tissue without the loss of surface dose coverage in the planning target volume (PTV).

In recent years intensity-modulated RT and volumetric-modulated arc therapy (VMAT) have been adopted for the use of breast or chest wall treatments mainly through the use of hybrid plan using open tangential field with intensity-modulated radiation therapy and volumetric-modulated arc therapy (VMAT) treatments. For patients presenting with challenging anatomical features, bilateral breast treatment or have inter-mammary nodes involvment which require specific dosimetric constrainst and conformity, VMAT has been used to achieve better conformity and homogeneity. However the use of VMAT has been limited due to concerns of increased low?dose wash and potential secondary malignancy risk.

The presentation will review and discuss the current literature on VMAT breast planning  and planning strategies in the planning of VMAT for breast.

Learner Outcomes: 

1. Explain the different techniques used in breast treatment planning
2. Outline some of the concerns regarding VMAT planning for Breast
3. Describe the different planning strategies use in VMATbreast Planning
4. Discuss some of the beam parameters used in VMAT Breast planning

Presenter:
Tan Chek Wee, MSc, BSc, Dip, CMD, is currently working as a Senior Principal Radiation Therapist at the National University Cancer Institute, Singapore. She graduated with diploma in Radiotherapy from School of Radiography in Singapore and went on to obtain her Bachelor degree in Radiographic Studies with London South Bank University. She is also a certified medical dosimetrist with the Medical Dosimetry Certification Board in the United States and obtained her Master of Science in Radiotherapy Planning with Sheffield Hallam University.

Educational Level: Intermediate

ARRT CQR Credit Distribution
Radiation Therapy 2017:
Procedures        
  Prescription and Dose Calculation = 0.50
  Treatments = 0.50
Radiation Therapy 2022:
Procedures   
  Prescription and Dose Calculation = 0.50
  Treatments = 0.50