Breast and Chest Wall

This chapter provides a comprehensive review of radiotherapy treatment planning for breast cancer, a complex and highly individualized process influenced by tumor location, disease extent, patient anatomy, and the proximity of critical organs. Key aspects of simulation are addressed, including considerations for patient positioning in both supine and prone setups to enhance reproducibility and optimize beam geometry. We examine three-dimensional conformal radiotherapy (3DCRT) techniques, particularly for their advantages in minimizing low-dose exposure to the contralateral normal tissues. The chapter also explores the growing role of advanced modalities such as volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT), which offer superior dosimetric flexibility for anatomically challenging or node-positive cases. Emphasis is placed on practical guidance for the rigorous evaluation of treatment plan quality to ensure the safe, effective, and personalized delivery of breast cancer radiotherapy.