Do you use traditional bony landmarks or contoured nodal volumes when designing breast and supraclavicular treatment fields?  

The classic field borders and blocks that I was trained with in the 2-dimensional era, result in almost the same field as those achieved by laboriously contouring the nodal volumes and expanding them. That is a testimony to our predecessors’ knowledge of anatomy, clinical examination of patien...

Do use bony landmarks like the lower end of the clavicle head to set isocenter for three field. But don’t use bony mark and use nodal contouring to decide the field border and if needed to adequately cover at risk level one node, then part of the humerus head may be in volume.

This thread brings up the question that we have faced over the decades: just because we can do something in a more complicated way doesn’t mean we should. I remember debating the pros and cons of divergent cerrobend blocks! In this instance, we know the anatomy and the target. Why do we still ...