Poster - 34: Clinical Implementation of Prone Breast Treatment




Prone breast treatment is used to reduce acute and late toxicities for large or pendulous breast patients. This study developed and implemented the clinical workflow of prone breast radiotherapy treatment.


Varian kVue Access360™ Prone Breast Couchtop was used as prone breast board. The treatment planning (TP)is performed in Eclipse TP system. TP comparisons between supine deep inspiration breathing hold (DIBH) and prone breast; prone forward field-in-field (FinF) planning and inverse IMRT planning were performed and discussed. For the daily setup, breast coverage was assessed in the room using light field and MV imaging was used at day 1 and weekly.


The first ten patients are CT scanned and planned both supine and prone. The coverage was all excellent for supine DIBH plan and prone breast plan. The plan in the prone position demonstrated improvements in lung sparing comparing to the DIBH plan. Both forward FinF plan and inverse IMRT plan achieved acceptable coverage of the breast, and heart dose is comparable. Considering the daily setup variations and MLC leakage, forward FinF plan was recommended for routine clinical use. The procedure has been tested in phantom and patients were treated clinically.


Prone breast irradiation has been advocated for women with large pendulous breasts in order to decrease acute and late toxicities. The workflow for prone breast radiation therapy has been developed and the technique is ready to treat patients.