When do you consider using protons for breast cancer?  

I think there is a limited role for protons in breast cancer outside of prospective studies at this time.With respect to partial breast irradiation, while initial trials showed some higher skin toxicities, modern institutional series have shown much better outcomes. That being said, the total number...

At our center, all patients for regional nodal radiation (including IMNs) are recommended to participate on RADCOMP. This study will be tremendously important to understand if real-world implementation of breast proton therapy in the highest risk group (treatment of the IMNs) will be beneficial. We ...

I consider the use of protons for women with non-metastatic breast cancer requiring internal mammary lymph node irradiation or a tumor in the breast or chest wall in a location close to the heart (left medially located tumors). The benefit is highly individualized based on patient anatomy and what i...

I often find the need to use proton therapy during left chest wall comprehensive nodal irradiation when including the internal mammary nodes and mastectomy scars, which can be quite long.  These patients are often stage N1-N2, T3-T4, or both. These conventionally require multiple matched fields...