Provided herein is a radiotherapy breast board and couch for use in radiotherapy treatment of breast cancer patients, which are particularly suitable for treating the patient to the breast/thoracic wall and regional lymph nodes in prone position. The radiotherapy breast board and couch comprises a caudal part for supporting the lower body of the patient and a cranial part with supports for the head and non-treated parts of the upper body. The board or couch further provides an opening allowing for the affected breast of the patient to pass through and an opening allowing for the regional lymph nodes to pass trough as said patient lies in a prone position on said board or couch. This opening allows the use of a variety of beam directions to reach the affected region via short radiological path lengths without passing elements of the breast board or couch.