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Irradiation with standard tangential breast fields in patients treated with conservative surgery and sentinel node biopsy: using a three-dimensional tool to evaluate the first level coverage of the axillary nodes

¹ Division of Radiotherapy, ² Division of Senology, ³ Medical Physic Unit, European Institute of Oncology, Milan and ⁴ University of Milan, Milan, Italy

View larger version (11K): [in a new window]   Figure 1. Mean total doses absorbed in the first axillary level, with standard therapy of 50 Gy, in 2 Gy fractions.

View larger version (21K): [in a new window]   Figure 2. Volumetric coverage of the first axillary level.

View larger version (25K): [in a new window]   Figure 3. Dose–volume histograms (DVHs) of the first axillary level for all patients.

View larger version (13K): [in a new window]   Figure 4. Minimum, maximum and mean dose–volume histograms (DVHs) of the first axillary level.

View larger version (70K): [in a new window]   Figure 5. First level axillary lymph nodes contoured on CT slice (arrow) and its relationship to the upper border of planned tangential fields.

View larger version (118K): [in a new window]   Figure 6. Surface rendered image of tangential portals of a typical patient, showing breast target volume, underlying lung and first axillary node level (arrow). Note that the first level nodes are only partially included within the tangential fields.