{Reference Type}: Journal Article {Title}: Vessel based delineation guidelines for the elective lymph node regions in breast cancer radiation therapy - PROCAB guidelines. {Author}: Verhoeven K;Weltens C;Remouchamps V;Mahjoubi K;Veldeman L;Lengele B;Hortobagyi E;Kirkove C; {Journal}: Radiother Oncol {Volume}: 114 {Issue}: 1 {Year}: Jan 2015 {Factor}: 6.901 {DOI}: 10.1016/j.radonc.2014.11.008 {Abstract}: OBJECTIVE: A national project to improve the quality of breast radiation therapy was started, named PROCAB (PROject on CAncer of the Breast). One of the objectives was to reach a national consensus guideline for the delineation of the regional lymph node areas in breast radiation therapy.
METHODS: The realization of the new guidelines was a step by step process that started with multiple expert meetings where the existing guidelines were analyzed and the delineations of the lymph node regions were performed together with a surgeon, specialized in the anatomy of the drainage of the breast.
RESULTS: The delineation guidelines are vessel-based. Since the occurrence of pathological lymph nodes is typically around the veins, the cranial and caudal borders of all different nodal regions are based on a 5mm margin around the veins, except for the parasternal lymph node area. Compared to the existing guidelines there are some major changes.
CONCLUSIONS: With this project a national as well as a European (ESTRO) consensus guideline for the delineation of the regional lymph node areas in breast RT is reached. The new delineation atlas is vessel-based and no longer field-based.