The impact of anthropometric measurements on radiotherapy planning for patients with breast cancer

Background: In the management of breast cancer, radiotherapy plays a crucial role, especially in managing local tumor control. To achieve the best possible outcomes while fully protecting normal tissues, it is important to consider anatomic variations, which can differ between individuals and significantly impact treatment field designs. Materials and Methods: The study involved 40 patients with breast cancer who underwent breast-conserving surgery (BCS) and received both whole breast and lymph node irradiation. The study evaluated the impact of anthropometric characteristics including weight, mid-sternum thickness, Haller index, central lung distance (CLD), and breast volume on the doses of organs at risk (OARs). Results: Breast size was found to be an important factor in determining lung doses. Patients with larger breasts had higher ipsilateral lung doses compared with those with small or medium-sized breasts. On the other hand, patients with mid-sternum thickness above 1.7 cm had higher contralateral breast doses. As expected, patients who received internal mammary nodal irradiation had higher lung doses and contralateral breast doses compared with those who did not. Conclusions: In the radiotherapy of breast cancer, it is important to consider treatment portal designs based on anthropometric variables to reduce the doses of organs at risk. Contralateral breast doses in patients with high mid-sternum thickness and lung doses in patients with large breasts should be carefully and treatment options should be evaluated accordingly.