Do you use breath hold techniques to minimize heart dose in whole breast radiation?  

We do 2 CT scans (free breathing and deep breath hold) for every patient with left sided breast cancer treated in the supine position. We then create volumes and blocks for both scans and select the DIBH plan if it offers a clear advantage. Our approach is to attempt to keep mean heart dose under 1 ...

I agree that it is important to obtain both the free breathing and the breath hold scan for all supine left-sided cases.  This gives the physician the freedom to plan on either scan and to compare, and to plan the boost on the free breathing scan even if breath hold is chosen for the primary tr...