Radiation therapy in breast conservation

Decreasing local failures with maintaining the full merits of cosmesis is required in breast conservation for patients with breast cancer. The methods of radiation therapy are described. The breast and chest wall is irradiated tangenitally to a total dose of 45 to 50 Gy with a conventional fractionation of 1.8 to 2.0 Gy per day. No bolus is used unless the skin is directly invaded. The axilla is not irradiated after complete or partial dissection. The significance of irradiation to the supraclavicular or internal mammary lymph nodes has not been proved. The use of wedge pair is recommended according to calculation of dose distribution based on CT findings. (author)