Comparison of contralateral breast doses from 1/2 beam block and isocentric treatment techniques for patients treated with primary breast irradiation with 60CO.

The risk of carcinogenesis in breast tissue subject to low to moderate radiation doses may be of concern to the clinical radiotherapist. With earlier diagnosis, more women, and especially younger women, are electing breast preservation radiation therapy. During therapy, tissue outside the treatment field is exposed to leakage and scattered radiation. Such exposure could lead to significant doses of radiation resulting in carcinogenesis. Therefore, reduction of contralateral breast dose may be an important factor to consider when selecting a treatment technique. This study measured dose in the contralateral breast on 15 patients treated with 60Co gamma rays with the source to skin distance (SSD), 1/2 beam block, and the source to axis distance (SAD), no 1/2 beam block, techniques. Thermoluminescent dosimeters (TLD), with 0.5 cm of superflab used as build-up material, were placed on the contralateral breast to measure dose from the medial tangential beam and from the lateral tangential beam. Dose measurements were done on patients in the treatment position and do not represent phantom or formula calculation of dose to the opposite breast. Our results indicated that total opposite breast dose ranged from 325-650 cGy for SSD treatments as opposed to 200-450 cGy for SAD treatments, in patients receiving a total prescribed dose of 5,040 cGy in 28 fractions to the involved breast. This paper points out that a simple solution for reduction of opposite breast dose for patients treated with 60Co may be utilization of the modified SAD treatment technique.