Do you ever use VMAT for breast cancer?   

For standard tangents, I do not use VMAT, and use field in field. For locally advanced breast cancer, I almost always use 3DCRT with rare use of IMRT for cases primarily where I am treating IM nodes and reconstruction is present and a 3DCRT plan cannot meet constraints. I have used VMAT in a few of ...

I consider IMRT/VMAT for complex RNI/PMRT cases when meeting constraints with 3D is challenging (when more comprehensive coverage is desired, unusual anatomy/chest shape).  One disclaimer is that Mayo Clinic has Proton therapy, which is a really nice solution for many complex/comprehensive plan...