Are there certain clinical scenarios that make you favor a lower whole breast total dose but higher lumpectomy cavity boost?   

In patients with large breast size where dose homogeneity is not optimal we do 45 Gy in 25 fraction to breast and 16 gy boost for total dose of 60 Gy to the surgical bed site.

Both Dr. Freedman and Dr. Formenti have published data on concomitant boost with IMRT , although the whole breast fractionation scheme in both studies was not standard fractionation but rather a hypofractionated regimen ranging from 2.25 to 2.7 Gy per fraction. Hopefully results of the recently comp...