Synchronous bilateral breast irradiation with helical tomotherapy: A single institute experience

Purpose: Synchronous bilateral breast cancer (SBBC) occurs in less than 3% of patients with breast cancer. Radiation delivery using conventional techniques leads to poor dose coverage and high toxicity. With improved radiation techniques, such as helical tomotherapy, favorable dose coverage and low toxicity profiles can be achieved. Methods: From February 2011 to February 2014, 3 patients were diagnosed with SBBC and treated with synchronous bilateral whole breast irradiation (SBWBR). The characteristics, radiation planning parameters, and treatment toxicity (acute and late) data of these patients were collected. Results: All 3 patients received bilateral breast-conserving surgery followed by chemotherapy and SBWBR. The average irradiation volume was 1215.4 cm^3. The average dose to breast tissue was 50.4 Gy. Only grade 1 acute skin toxicity was reported. After a median follow-up time of 48.7 months, all patients were alive without long-term toxicity. Conclusion: Helical tomotherapy is a feasible radiation treatment for patients with SBBC suited to SBWBR. Its advantages include favorable dose coverage, low skin toxicity, and no long-term side effects.