?), andwith the use of IMRT, there is a reduction in the absolute heart volume receiving 25 Gy or higher by at least 20% (e.g., volume predicted to receive 25 Gy by 3D RT is 20 cc and the volume predicted by IMRT is 16 cc or less).The following are examples of criteria to define large breast size when using IMRT to avoid hot spots, as derived from randomized studies:Donovan and colleagues enrolled