Use of CT scanning to optimise the localisation procedure for breast radiotherapy

The continually improving technology in breast screening is now allowing diagnosis of patients with early stage breast cancer who would otherwise not have presented for many years. Surgical techniques are directed to achieving the best possible cosmetic result following the surgery. Radiotherapy treatment machines are becoming more complex and sophisticated in design and capability. Why, therefore, should we not employ today's technology for the localisation process? This is a report of our experience in using CT scanning to localise the treatment volumes for breast patients over a period of one year. A comparison between marking patients by palpation and the use of CT scanning has prevented a number of patients being under-treated and has enabled the reduction of lung volume included in the treatment volume for other patients. It has also proved a valuable aid in the decision to use electron fields for mastectomy patients. Other means of localising the treatment volumes are considered in the light of our experiences.