الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Breast cancer management cause many side effects acute & late Lymphoedema is one of the most common late side effects usually related to surgery and radiotherapy due to obstruction and disruption of lymphatic channels.
The study aims to correlate between different radiotherapy techniques, fractionation and doses received by each axillary LN level, supraclavicular, axillary vessels with the degree of breast cancer related lymphodema.
We retrospectively assessed 183 female breast cancer patients who were diagnosed and treated by surgery, chemotherapy and radiation therapy during the period from January 2012- December 2018. The radiotherapy treatment plans were recalled from the archives .The axillary LN levels I II III and supraclavicular were contoured according to RTOG guidelines as well as axillary vessels .A new DVHs were generated to correlate between the radiotherapy dose to those structures and the development of breast cancer related lymphodema.
Then assessment for lymphodema for 3 times at 0, 3, 6 months and contouring of all axillary levels I, II, III, Supraclavicular and axillary vessels.
Statistical analysis of the results revealed that Cumulative incidence of BCRL after surgery, RLNR is 21-23%. There was a statistically significant relation between 2D radiotherapy technique compared with 3DCRTand development of lymphoedema (P=0.0001). patients who were treated with conventional radiotherapy (50 Gy/25 fr) had significantly higher rates of lymphedema compared with hypofractionation radiotherapy (40 Gy/15) 42.5%, 8.5% respectively with a P value of <0.0001.
However, Type of surgery, LN positivity have no direct effect on development of lymphedema with a P value of 0.18, 0.666 respectively.