Imaging for early stage breast cancer

4D measurement of the displacement of internal fiducial and skin markers

4D CT was done for 20 breast patients

movement of skin markers and internal tumor bed fiducials was studied

intrafractional errors from respiratory motion was assessed

Max < 3 mm !!!

motion management like gating or 4D-CT is unnecessary for breast treatments

the motion is within 3 mm and this can be encompassed by CTV-PTV extensions

AAPM TG 76 recommend motion management techniques only if tumor motion is > 5 mm

Yamashita et al. IJROBP 84:331-335. 2012