Intensity-Modulated Radiation Therapy for Breast Cancer

Over the past 2 decades, numerous advances and innovations have occurred in all technical aspects of radiation therapy (RT), including three-dimensional (3D) treatment planning, conformal radiation delivery, intensity-modulated radiation therapy (IMRT), patient immobilization, and precise treatment verification. Despite incredible progress on all fronts, standard RT for breast cancer has changed very little and has not fully exploited many of the advances commonly used to treat most other malignancies. Increasing data have also accumulated, indicating that dose non-uniformities within the breast with traditional RT techniques can be greater than in many other anatomic sites. These significant dose inhomogeneities can produce unnecessary acute and chronic toxicities as well as unacceptable long-term cosmetic results. In addition, the lack of accurate verification of target volume coverage (e.g. lumpectomy cavity or chest wall) may result in diminished tumor control.