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Spine-sparing postmastectomy irradiation.

Postoperative irradiation of the chest wall and regional lymphatics following mastectomy for operable breast carcinoma is an effective means of reducing the chance of postoperative locoregional recurrence. The majority of patients who fail will ultimately develop bony metastases, especially in the thoracic and lumbar spinal regions. Our technique of postoperative irradiation avoids exit irradiation of the spine. This is important for patients who may later develop bony metastases or epidural spinal cord compression and require spinal irradiation. The details of the technique are presented.