Localising the Tumour Bed in Breast Radiotherapy

Abstract

After complete microscopic resection of primary tumour in women with early breast cancer, most local tumour relapses present close to the primary tumour [1]. It is therefore important to ensure that the tumour bed lies well inside the treatment volume encompassed by tangential fields to the whole breast and subsequent tumour bed boost. The penalty for geographical miss is severe: four local tumour relapses cause, on average, one death from breast cancer [2]. The optimal margin to add to the excision cavity for whole breast radiotherapy and the tumour bed boost remains controversial, but there is general agreement that the excision cavity itself must always lie inside the high dose envelope.