Do you try to cover the entire mastectomy scar with PMRT even if it crosses over midline to contralateral side?  

I usually cover the entire mastectomy scar even if it extends to contralateral side. This usually happens in locally advanced cancer or medial quadrant disease. Sometimes I add a matching electron beam to cover the medial edge of scar if the tangential beam increases normal tissue dosimetry. Detaile...

I  typically will try to cover the entire within the tangential fields (or using IMRT if dose constraints can not be met using standard tangents) as this will allow for the best possible homogeniety of dose.  The tagential fields can be opened medially at in the region of the scar.  F...