Breast Contouring Regional Nodes... a Walkthrough

This video teaches Breast contouring for regional nodal irradiation (RNI). We hope you find it fun, practical, and easy to understand!
If you would like to support this video with your feedback, please share your experience with us here! bit.ly/breastcontourvideo
To watch this video with a full written transcript and searchable text, check out this link (and feel free to share!): share.descript.com/view/uaNZV...
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There are also several pdf resources that we recommend in case you have not seen them yet:
RADCOMP Atlas for IMRT treatment planning: www.nrgoncology.org/Portals/0...
Mapping out Regional Nodal Recurrences in Breast Cancer - DeSelm et al. 2021: www.ncbi.nlm.nih.gov/pmc/arti...
Comparison of different consensus guidelines in breast cancer and patterns of failure: onlinelibrary.wiley.com/doi/1...
Older Atlases for 3D-CRT (not covered in this video):
RTOG guidelines (USA, 3D-CRT = bone/muscle-based): www.nrgoncology.org/Portals/0...[74].pdf?ver=uflhUn_dY0Rwfp69kGkX-g%3d%3d
ESTRO guidelines (Europe, 3D-CRT = vascular-based):
- ESTRO consensus guideline for elective radiation therapy of early stage breast cancer - Offerson et al. 2015: www.thegreenjournal.com/artic...
- Updated version 1.1 - Offerson et al. 2016: www.thegreenjournal.com/artic...
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All information in this video is for educational purposes only. Even experts debate contours, but this is simply meant to provide a safe and acceptable example of contours :) Remember to always use your own clinical judgement when making treatment-related decisions!
All contours use names according to the AAPM TG-263 nomenclature guide: www.aapm.org/pubs/reports/rpt...
00:00 Breast Contouring Regional Nodes... a Walkthrough
00:57 Checklist of Key Points
04:52 Structure Set Template
06:53 OARs: Heart sub-structures
15:01 OARs: Shoulder
16:18 OARs: Brachial Plexus
17:59 Targets: Chest Wall
21:26 Targets: Regional Nodes
22:03 Axillary Level 2 Nodes
26:34 Axillary Level 3 Nodes
28:51 Axillary Level 1 Nodes
33:43 Internal Mammary Nodes
40:11 Supraclavicular Nodes
42:43 Posterior Triangle of Supraclavicular Nodes
45:14 Final Review
49:08 The End
If you would like to support this video with your feedback, please complete this brief form, and thank you for your time! bit.ly/breastcontourvideo

[@RayosContraCancer]

Thank you everyone, we're glad this video is helpful! If you have 1 minute and would consider providing us with your feedback in this form, we would be very appreciative: bit.ly/breastcontourvideo
Together we raise against cancer!

[@dr.ahmadn.shamout3240]

really informative thanks a lot

[@KunKosh]

Thank you!

[@d0llseye]

Thank you

[@Drkp23]

Thank you. Please cover other areas also

[@TheKazimraza]

as an oncologist i appreciate ur good work 1 thing i want to add u have to tell indication for volumes to be added as per ASTRO guidelines and when not to include. overall best effort

[@RayosContraCancer]

There are 3 atlases with different histories:
- RTOG (USA, 3D-CRT = bone/muscle-based)
- ESTRO (Europe, 3D-CRT = vascular-based)
- RADCOMP (Proton vs. photon trials, VMAT)
Which Atlas should be used?
- For IMRT/VMAT, use RADCOMP. It's most generous field, designed for VMAT photon or protons.
- For 3D-CRT plans, don't use RADCOMP (unless you want to struggle with OAR constraints)
Hope this helps!

[@nugroho83dr]

excellent❤

[@mohamedfarouktube]

Nice work, Keep the flag flying high

[@saurabhborg]

Where is the video for contouring the brachial plexus ? Thanks

[@RafaelEduardoCervantesLopez]

buenas tardes, pregunta, estos videos tienen traduccion al castellano, gracias

[@pipocamaluca7502]

Rayos, congratulations for the good content. Im starting as a dosimetrist could you tell me a good website, materials or/and books to get more information about basics contouring as well fudamentals of it? Tks so much bro

[@RayosContraCancer]

We have another good video if you haven't seen, about contouring OARs in the head and neck region. This is one of the trickiest areas for beginners, and it has some good commentary about contouring in general during it too: th-cam.com/video/hvhKhMcfxY4/w-d-xo.html
A good book for contouring is Nancy Lee's "Target Volume Delineation and Field Setup" which has a chapter for each disease site.
For introduction to contouring targets (GTV, CTV, and PTV), we made a new playlist focused on cervical cancer, rectal cancer, prostate cancer, anal cancer, and other pelvic malignancies here: th-cam.com/video/A7HzrVszTyU/w-d-xo.html&pp=gAQB
Lastly, once you have the hang of things, we highly recommend making a free account at www.econtour.org which has many more guides and examples across different disease sites for everything related to contouring!

[@bayronramiroreyespabon8913]

Traducir al español

[@RayosContraCancer]

Puede ver los subtítulos en español activando los subtítulos ("cc") y luego haciendo clic en configuración (el icono de engranaje) -> subtítulos -> Inglés traducido automáticamente, luego una vez más haciendo clic en configuración -> subtítulos -> y esta vez " Traducir automáticamente" donde puede seleccionar español o cualquier otro idioma.
Este artículo también lo explica: www.online-tech-tips.com/computer-tips/how-to-use-auto-translate-and-closed-captions-for-youtube-videos/
¡Buena suerte!

[@RayosContraCancer]

You can see the subtitles in Spanish by turning on closed captions ("cc") and then clicking settings (the gear icon) -> subtitles -> English Auto-translated, then once more clicking settings -> subtitles -> and this time "Auto-translate" where you can select Spanish or any other language.
This article explains it as well: www.online-tech-tips.com/computer-tips/how-to-use-auto-translate-and-closed-captions-for-youtube-videos/
Good luck!