The impact of breast size on mean lung dose for patients receiving tangential radiotherapy to the whole breast

Abstract

Purpose: To explore the impact of breast size on mean lung dose (MLD) for patients receiving breast radiotherapy. Methodology: Chest wall separation (CWS), volume of tissue receiving 95% isodose and MLD were measured on 80 radiotherapy treatment plans of patients receiving tangential radiotherapy treatment to the whole breast. Breast size was categorised as small (CWS<25 cm and planned target volume (PTV)<1,500 cm3) and large (CWS>25 cm and PTV>1500 cm3). Pearson’s correlation and independent sample t-test were used to analyse data. Results: MLD was not affected by CWS (r = −0·13, p = 0·24) nor volume of tissue receiving 95% isodose (r = −0·08, p = 0·49). Significant variation between small and large breasts was noted for CWS (t = 8·24, p = 0·00) and volume of tissue receiving 95% isodose (t = 5·68, p = 0·00). No significant variation was noted between small and large breast for MLD (t = −0·26, p = 0·80) and between left and right breasts for CWS (t = 1·42, p = 0·16) and volume of tissue receiving 95% isodose (t = −1·08, p = 0·28). Significant difference between left (18–808 cGy) and right breast (325–365 cGy) was demonstrated for MLD (t = 3·03, p = 0·00). Conclusion: This study demonstrated lack of correlation between breast size and MLD. Further research is recommended for justification of alternative techniques for this subgroup of patients to provide optimised radiotherapy delivery.