ExacTrac Dynamic Surface-Guided Setup Versus Tattoo-Based Positioning in Breast Cancer Radiotherapy: A Retrospective Comparison of Setup Accuracy and Preparation Time

Background/Objectives: Accurate and reproducible patient positioning is essential in breast cancer radiotherapy to ensure target coverage while minimizing exposure to surrounding healthy tissues. Conventional tattoo-based alignment remains widely used but has inherent limitations, including variability, potential setup errors, and negative psychological impact from permanent markings. Surface Guided Radiation Therapy (SGRT) using ExacTrac Dynamic (ETD) offers a non-invasive, real-time alternative that may improve workflow efficiency and patient experience. This study evaluated the accuracy and efficiency of ETD compared with conventional tattoo-based setup in breast-only radiotherapy.