In 3D-CRT of breast cancer, we hardly find something special (and useful), but we may (or should): – Really know our linac and TPS – Get most of every beam we use – Get most of every MU we irradiate – Save every millimeter we can save – Save every percent we can save – Use proper plan normalization – Think about plan robustness and technical realization Basic field geometry is always the same – Using half beams (1 isocenter) or beam matching (2 isocenters) – Two tangential fields for breast – Two fields for axilla and supraclavicular nodes – And some low-weight fields for dose distribution improvement Used equipment: – TPS Eclipse 8.6, AAA algorithm – Clinac 600C (X 6MV), MARK52 MLC Following the competition criteria (1 isocenter), I was not able to use my MLC because of insufficient range, so I used blocks In practice, I use 2 isocenters and non-coplanar fields as a simple way to extend my MLC range You can use standard 80 or 120 leafs MLC with similar results as I have got with blocks, just use the MLC instead of blocks I don’t think the presented plan is a good plan, it is just a plan that tries to meet the competition criteria – and there are no criteria for plan robustness, dose to larynx, integral dose…, however you can simply modify it to meet your own criteria Find out the plane, where PTV shape changes significantly Usually few millimeters below supraclavicular nodes Add some wedges – Usually 15° for breast tangential fields – Wedges for supraclavicular/axillar fields are strongly dependent on gantry angles Adjust field weight – Just by your experience Choose the right plan normalization – In this case, D99%=95% means 15 points for you;) Calculate the dose distribution