Radiation Therapy for (Left) Breast Cancer with Cardiac / Heart Protection

Breast cancer is one of the most common cancers among women. Good news is, that many more patients today are long term breast cancer “survivors” with good quality of life because of advances in treatment.

Standard local treatment for breast cancer includes mastectomy or breast conservation surgery followed by chemotherapy and radiation therapy (RT).

Radiation therapy is an essential part of breast cancer treatment as it has been shown to decrease re – occurrence of cancer in breast/chest as well as improve survival rates of patients.

In radiation therapy for left breast cancer, there has always been big concern about safety of radiation doses to heart.

Fortunately, radiation therapy techniques have improved markedly in last few years with special attention to make it more focused and precise to decease its side effects.

Department of Radiation Oncology at Max Super specialty hospital, Shalimar Bagh, is a comprehensive department equipped with latest high end equipments like TrueBeam STx Linear Accelerator, 4 D CT simulator and HDR Brachytherapy to safely do heart sparing left breast cancer RT. 

We are equipped with several techniques to protect heart and Lungs while treating breast cancer patients with radiation therapy some of which are mentioned below.

Deep Inspiratory Breath Hold (DIBH):

Deep inspiration breath hold (DIBH), is a radiation therapy technique where patient is trained to hold   breath in deep inspiration. By holding breath in deep inspiration,  patients  fill extra air in lungs which moves heart away from breast/ chest and decreases dose to heart and lungs (as shown in figure 2). Radiation beams are synchronised with patient’s breathing cycles, such that radiation is delivered only when patient is in DIBH using RPM (Respiratory Motion Management Camera). This is also called as 4 D Radiation Therapy where 4th dimension is time.

DIBH is an excellent technique technique for protecting heart and lung while doing radiation therapy for left breast cancer. 

Prone Position:

At times patients are treated in prone position such that breast falls away from chest wall and hence increases distance from the heart to chest wall/breast. (Figure 3) This also helps considerably in decreasing doses to heart. 

Partial Breast Irradiation (PBI):

In case of early breast cancers with favourable molecular profile, sometimes instead of treating whole breast, only small area around the breast tumour is treated with radiation therapy. This is called as partial breast radiation which also significantly reduces dose to heart. 

Message :

With the present precise and advanced technologies, radiation therapy has become safer for breast cancer by protecting underlying heart and lungs.