Additional Assignment #1
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Washington & Leaver: Principles and Practice of Radiation Therapy,
3rd Edition Chapter 38: Breast Cancer
1. Describe the lymphatics associated with the breast. Axillary - Most of the breat drains into the axillary lymph nodes. There are about 20-30 axillary lymph nodes located in the underarm area. They are divided in different group. They include subscapular, apical, pectoral axillary, brachial and central lymph nodes.
SCLV- They are lymph nodes that are found to be superior to the clavicle. The most notable SCLV node is virchow's node.
Internal Mammary-
2. Briefly describe the role of surgery in the treatment of breast cancer.
· There can be a lumpectomy in which the doctor removes only the breast lump and some surrounding margin around the normal tissue. Mastectomy is a surgery to completely remove the entire breast. A radical mastectomy removes the entire breast, axillary lymph nodes and pectoral muscles under the breast.
3. Describe the role of chemotherapy in the treatment of breast cancer.
· Chemeotherapy works by allowing the medicine to flow through the bloodstream and destroy cell cells or stopping them from divide.
4. What is tamoxifen and how is it used in the treatment and prevention of breast cancer?
§ Tamoxifen is a chemotherapy agent that interfere with estrogen’s ability to simulate growth of breast cancer cells.
5. Describe in detail the role of external beam radiation therapy in the treatment of breast cancer including positioning, dose, treatment techniques, side effects, outcomes, etc. o Radiation is usually used on the area in which the excision has taken place. This is usually around the scar region. Usually the patient is lying on the breast board on a 15 degree incline and arms are above the head. The chest wall is treated isocentrically by a pair of wedged tangential fields. The dose is 50 Gy in 25 fractions. Side effects include desquamation ,erythema and darkening of skin.
6. Define the field edges of the tangent treatment fields if no IMC is used.
Medial border – midline of the bod
Lateral border – midaxillary line
Superior border – suprasternal notch
Inferior border – 1 - 2 cm inferior of the inframammary fold
7. What is the gantry angle for the SVC field and why?
The gantry angle is 10 degress from ap to avoid spinal cord.
8. Define the field edges of the SCV treatment field.
Medial border –At the pedicle of spinal cord
Inferior border – At the border of the tangent field
9. What is one advantage to interstitial brachytherapy for breast cancers? · There are fewer treatmens
10. What is the other name for the left supraclavicular lymph node? · Virchow's node
Washington & Leaver: Principles and Practice of Radiation Therapy,
3rd Edition
Chapter 36: Gynecological Tumors
1. Briefly describe the role of surgery in the treatment of gynecological cancers.
· Surgery is usually used to remove as much of the tumor as they can. Reducing the size of the tumor allows for outcomes from chemotherapy and radiation therapy.
2. Describe the role of hormone therapy in the treatment of endometrial cancer.
· Progestin are the main hormone treatment for endometrial cancer. These work by slowing the growth of endometrial