ESTRO Multidisciplinary Management of Breast Cancer 2017

How to reduce the boost volume ?

• Pathology; discuss with your pathologist:

• Free margins in 6 directions  smaller delineated CTV

• Surgery; discuss with your surgeon:

• Limit excision volumes; no tumor on ink is sufficient ! • Limit size of seroma cavity • Place clips to reduce uncertainty  to reduce volume • Avoid oncoplastic surgery in case of indication for boost ?

• Chemotherapy: • If required anyway: consider to give it upfront  Smaller tumor, smaller excision volumes. • Consider to give it prior to RT to increase time between OK and RT ?