FIGURE 4. Intraoperative radiation therapy for breast cancer using a linear accelerator at the Instituto Europe di Oncologia in Milan, Italy. A, To minimize radiation to the thoracic wall, an aluminum-lead disk is placed between the deep fascia of the breast and the pectoralis muscle prior to start of radiation therapy. B, Placement of the linear accelerator applicator with complete retraction of the skin to prevent radiation injury. Photos from Veronesi et al⁴¹; reprinted with permission.