Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
Year : 2020  |  Volume : 16  |  Issue : 6  |  Page : 1350-1353

Incidental radiation dose to internal mammary lymph nodal area in carcinoma breast patients treated with forward planning intensity-modulated radiation therapy technique: A single-institute dosimetric study

1 Department of Radiation Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
2 Department of Radiation Oncology, Mehdi Nawaz Jung Institute of Oncology and Regional Cancer Centre, Hyderabad, Telangana, India

Correspondence Address:
Aparna Suryadevara
Department of Radiation Oncology, Basavatarakam Indo.American Cancer Hospital and Research Institute, Banjara Hills, Hyderabad, Telangana
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_225_19

Rights and Permissions

Introduction: Breast cancer (BC) is the most common cancer in Indian females. The irradiation of internal mammary lymph nodal area (IMLN) is recommended by latest guidelines and literature, even in patients with N1 nodal disease, but it is not routinely done in many institutes due to the risk of late lung and heart toxicities. The incidence of isolated IMLN recurrence <1%. The incidental radiation therapy (RT) dose to axillary lymph nodal area (ALN) could result in lower local recurrences according to literature. The aim of this study is to assess the incidental IMLN area RT dose in patients treated with forward planning intensity-modulated RT (FIF-IMRT). Materials and Methods: The aim of our study is to evaluate the RT dose received by IMLN area incidentally in FIF-IMRT and is a single-institute dosimetric study. The patients planned for RT after breast conservation surgery (BCS) or modified radical mastectomy (MRM) were evaluated for IMLN incidental dose. Results: The mean doses to IMLN area (Dmean) were comparable to literature for both BCS and MRM patients. All other dose parameters (D95, D90) in our study were slightly lower but comparable to literature for the FIF-IMRT planning. Interestingly, the incidental IMLN RT doses in our study are in the same range as the incidental ALN RT doses studied in the literature (48%–68%). Conclusion: The IMLN area receives a major amount of incidental radiation dose during conformal RT by FIF-IMRT and higher doses for MRM than BCS. This RT dose is not in the therapeutic range but is comparable to the incidental dose to ALN area reported in the literature.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded44    
    Comments [Add]    

Recommend this journal