IV. Medications
a. Citalopram
b. Methylphenidate HCI
c. Hydrocodone-acetaminophen
d. Percocet
e. Keflex
f. Tums
g. Melatonin
V. Diagnostic Imaging
a. Diagnostic mammogram 4/13/17
i. 3 cm mass in left breast
ii. 2.6 cm enlarged left axillary lymph node
b. FNA of left axillary node
i. Confirmed metastatic breast cancer
c. PET/CT
i. Showed hypermetabolic activity in left breast but no metastatic
disease
X. Beam Isocenter/Arrangement
a. Varian Trilogy machine
i. 6 MV VMAT plan
b. Isocenter placed roughly towards the center of the area being treated, but was
placed in air (iso placed more posterior than typical tangent field) since the plan
was done with arc’s instead of tangent fields and the fields had to go more
laterally to cover the IMN’s and axilla.
c. Field 1: Gantry 230-114 arc; Field 2: Gantry 114-2 arc; Field 3: Gantry 2-114
arc; Field 4: Gantry 114-230 arc.
i. 6 MV dynamic arc
1. Concerned about sparing dose to ipsilateral lung and heart
without sacrificing coverage to IMN and axilla
2. Partial arcs used to avoid dose to contralateral lung
[Type here] [Type here] Bianca Tester
XIII. Conclusion
a. Guidelines for B-51 clinical trial and how constraints effect treatment
planning
b. Things I struggled with
c. Things I learned/how this enhanced my understanding of dosimetry