Imaging for early stage breast cancer

How to avoid the late side effects with APBI ??

(1) Respect guidelines or recommendations of „positive trials“ ~ respect constraints !

Constraints

Organ

Constraints

V PD  300 cm 3

Treatment

DNR  0.35

volume

Ipsilateral non-target

V 90

< 10%

breast

V 50

< 40%

V 100  90%

Skin (5 mm)

D 1cm 3

< 90%

V 150 < 65 cm 3

PTV

D 0.2cm 3 <100%

V 200 < 15 cm 3

Rib

D 0.1cm 3 < 90%

COIN  0.65

D 1cm 3

< 80%

Heart (mean heart dose)

MHD < 8%

D 0.1cm 3 < 50%

Ipsilateral lung

MLD < 8% ; MLD < 1-1,5 Gy ( stochastic effects )

D 0.1cm 3 < 60%

University Hospital Erlangen