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Postoperative Radiation Treatment of the Breast

Preparation

  • Review of operation protocol, histology results, receptor status, and indication for radiation therapy as well as adjuvant treatment.
  • The patient is examined and informed by the physician and nurse in an out-patient setting.
  • Routine blood tests and X-ray of thorax are taken. Other necessary examinations if necessary (for example ultrasound and cytology of actual tumors/seroma, bone scintigraphy, ultrasound of liver etc).
  • Patient lies in the supine position with arm support/holder. Breast board. Wing board.
  • Drawing of target volume is CT-based and will be the basis for the treatment planning.
  • Conventional simulation is rarely used, and only when the CT-based treatment planning are not possible to perform (most often due to reduced mobility of shoulder/arm). The target volum is defined by the superficial anatomical structures and by means of X-ray.
  • Fixation (boost)

NBCG recommends that all women having curative irradiation for breast cancer should have fT4, TSH, and anti-TPO taken prior to the irradiation.

Organs at risk

  • Heart
  • Lungs
  • Spinal cord 
  • Contralateral breast
  • Brachial plexus 

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