2. Breast Cancer
• Most common cancer in women
• Ductal carcinoma most common
• Treatment options:
– Surgery + radiation
– Surgery + radiation + chemo
– Surgery alone (mastectomy)
3. Breast anatomy
• Superior border- 2nd
costal cartilage
• Inferior border- 6th
costal cartilage
• Medial border- Sternal edge
• Lateral border- anterior axillary line
6. Immobilization and Positioning
• First concern is the movement of the arm
• Custom molds
• Wingboards
• Breast board
• Headrest
• Knee wedge
7. Simulation set-up
• Disrobe from waist up
• Lie supine, straighten patient
• 3pt set-up
• Both arms or ipsilateral arm only raised into
position
• Head straight or turned to contralateral side
• Wires and BBs
16. Hodgkins
• Very radiosensitive
• Bi-modal age range 15-24 yrs & 50+
• Cervical or supraclavicular 75%
• Mediastinal 60%
• Fever, night sweats, weight loss
17. Treatment
• Surgery to diagnose and stage
• Radiation alone
• Chemo alone
• Radiation and Chemo
18. Immobilization and Positioning
• Patient supine
• No headrest, chin extended
• Arms above head or akimbo
• Custom molds
• Site specific custom blocks
21. Lung Cancer
• Leading cause of cancer death in males and
females
• Chemo, surgery and radiation
• Routes of spread
– Cervical L.N
– Liver, brain, bones