Dose to lung in primary breast irradiation

Using anatomic data derived from computerized tomography (CT) scans of the torso, the volume of lung irradiated during primary breast treatment has been measured for a variety of irradiation techniques. Two-field tangential plans which are angled into lung to treat also the internal mammary nodes have been compared to three-field plans which include a separate internal mammary field (IMF). The volume of lung achieving high dose (>3000 rad) is similar in both techniques when photons only are used. Electron beam treatment of the IMF is successful in lowering the lung dose. Additional treatment plans that angle the IMF parallel to the tangential fields may offer some theoretical advantage.