Table 1 Guidelines of CTV delineation
CTV | Cranial | Caudal | Medial | Lateral | Ventral | Dorsal |
|---|---|---|---|---|---|---|
Breast | Upper border of palpable/visible breast tissue; up to the inferior edge of the sternoclavicular joint | Most caudal CT slice with visible breast/mammary fold | Medial border of palpable/visible breast tissue; maximally to the parasternal line | Lateral border of visible/palpable mammary gland | 0.5Â cm beneath skin surface (including visible breast tissue) | Anterior edge of the pectoralis major/intercostal muscles/ribs |
Axillary level I | 0.5Â cm cranial to axillary vein | Level of 4th anterior rib, including postoperative change of SLNB | Axillary level II; chestwall | The line between pectoralis major and deltoid/ latissimus dorsi | Pectoralis major; pectoralis minor | Thoracodorsal vessels; the line between intercostal muscles and deltoid/ latissimus dorsi |
Axillary level II | Cranial edge of axillary artery | Caudal edge of pectoralis minor | Medial border of pectoralis minor | Lateral border of pectoralis minor | Posterior surface of pectoralis minor | 0.5Â cm dorsal to axillary vein; anterior edge of the intercostal muscles |
Axillary level III | 0.5Â cm cranial to subclavian vein | 0.5Â cm caudal to subclavian vein | Junction of subclavian and internal jugular veins | Medial border of the pectoralis minor | Pectoralis major | 0.5Â cm dorsal to axillary vein; anterior edge of the intercostal muscles |
INT | 0.5Â cm cranial to subclavian vein | Caudal border of CTV axillary level II | Medial border of pectoralis minor | Lateral border of pectoralis minor | Pectoralis major | Pectoralis mimor |
SCN | Caudal edge of cricoid cartilage | Junction of subclavian and internal jugular veins | Medial edge of the internal jugular vein, excluding thyroid and the common carotid artery | Sternocleidomastoid; the junction of clavicle and 1st rib | Medial edge of the sternocleidomastoid/clavicle | Ventral edge of the scalene muscle bundles |
IMN | 0.5Â cm caudal to subclavian vein | Cranial edge of 4th rib | 0.5Â cm medial to the internal thoracic vessels | 0.5Â cm lateral to the internal thoracic vessels | Ventral edge of the internal thoracic vessels | Parietal pleura |