How to choose the irradiation area for breast cancer radiotherapy

Breast cancer is one of the malignant tumors that endanger women's health. For breast cancer patients undergoing radiotherapy after surgery, it is critical to select a scientific and appropriate irradiation area. If the irradiation position is accurate and the target area conformity is good, the patient's treatment effect will be more ideal.

1. The target area and irradiation technique selection for breast cancer radiotherapy must consider three aspects, namely local tumor control, patient survival and complications. Especially for young patients or those with a long life expectancy, radiation complications are the key considerations.

2. The target areas for postoperative radiotherapy include the chest wall, supraclavicular area, axilla and internal mammary lymph nodes. Among them, the chest wall and supraclavicular area are the preferred target areas, while whether the axilla and internal mammary lymph nodes are the target areas for irradiation depends on different clinical situations.

3. For patients with complete axillary lymph node dissection and no extranodal invasion, axillary radiotherapy is not necessary regardless of the number of axillary lymph node metastases.

4. In radiotherapy of the internal mammary area, although irradiation of the internal mammary lymph nodes can reduce the local recurrence rate and improve the patient's survival rate, it may cause heart damage, so it should be chosen with caution.

5. To accurately determine the irradiation area, patients can undergo CT simulation positioning and use CT images as the basis for radiotherapy. For those who undergo radiotherapy after mastectomy, the mixed irradiation technology of electron beams and X-rays can achieve relatively ideal results.

6. Adjuvant radiotherapy after modified radical mastectomy for breast cancer: The irradiation sites for all patients are the chest wall and supraclavicular lymph node areas; the axillary area is irradiated for patients whose axillary lymph nodes have not been cleared or have been cleared incompletely; the internal breast area of ​​patients is generally not given routine treatment.

7. Adjuvant radiotherapy after breast-conserving surgery for breast cancer: The irradiation site for all patients undergoing breast-conserving surgery is the entire breast area; patients whose axillary lymph nodes have not been cleared or whose biopsy is positive but not cleared should also have the axilla irradiated; patients' internal breasts are generally not subjected to routine radiotherapy.