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Dose perturbation due to metallic breast expander in electron and photon beam treatment of breast cancer

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

The objective of this study is to investigate dose perturbations caused by metallic breast expander (MBE) and to compare the measurements with the treatment planning calculations in external beam radiotherapy.

Methods

A small water phantom with MBE was CT-scanned for treatment planning. Dose measurements were performed in the phantom with 6 and 15 MV photons and 9–22 MeV electrons in the water phantom and compared with treatment planning calculations.

Results

The measured dose for electron beam has pronounced backscatter (5 %) at the entrance and significant dose reduction up to 70 % on the exit side of the MBE, respectively. Monte Carlo calculation did not show backscatter, and the magnitude of the dose reduction was limited to only 30 %. The differences between measured and TPS are energy dependent that varied between −140 % and −80 % for 9–22 MeV beams. For photon beams, the backscatter dose perturbation is nearly the same for all algorithms as well as measurements, but in the transmission side, there are significant differences for all energies. The TPS algorithms are unable to show the effect of dose perturbation in photon beams that are generally 5–20 % lower in the breast tissue.

Conclusions

The dose perturbation in the presence of MBE was significant and could not be predicted with TPS. The differences could be due to CT electron density calibration and poor modeling in TPS algorithms for high-Z materials. It is concluded that high-Z materials should be avoided or measured data should be incorporated in the TPS for actual dose.

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Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Health Sciences, Purdue University, West Lafayette, IN, 47906, USA

    Shiv P. Srivastava, Chee-Wai Cheng & Indra J. Das

  2. Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA

    Shiv P. Srivastava, Chee-Wai Cheng & Indra J. Das

  3. Department of Radiation Oncology, Winthrop University Hospital, Mineola, NY, 11501, USA

    Janna Andrews

Authors
  1. Shiv P. Srivastava
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  2. Chee-Wai Cheng
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  3. Janna Andrews
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  4. Indra J. Das
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Corresponding author

Correspondence to Janna Andrews.

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Srivastava, S.P., Cheng, CW., Andrews, J. et al. Dose perturbation due to metallic breast expander in electron and photon beam treatment of breast cancer. J Radiat Oncol 3, 65–72 (2014). https://doi.org/10.1007/s13566-013-0109-4

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  • DOI: https://doi.org/10.1007/s13566-013-0109-4

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