Breast Cancer Radiation Treatment and the Effect on the Heart
Radiation therapy is often a key treatment for women with breast cancer. However, there can be concerns on how it may affect the heart if radiation is delivered to the left breast.
Neha Bhooshan, MD, PhD, radiation oncologist at the Center for Advanced Radiation Oncology at the Shady Grove Aquilino Cancer Center explains the effect that radiation can have on the heart and how radiation therapy technology has significantly improved to address this important issue.
“The heart is located under the left breast and when women receive radiation treatment on that side, understandably there is concern if the heart will receive radiation. Significant radiation dose to the heart can lead to scar tissue causing stiffness or weakness of the heart,” explains Dr. Bhooshan. According to a study in JACC: CardioOncology, women who had radiation therapy to their left breast between 1985 and 2008 had more than twice the risk of subsequent coronary artery disease than women who had radiation on their right breast.
Fortunately, since 2008, significant technologic advances have been made to breast cancer radiotherapy to limit radiation dose to the heart during treatment while still targeting the cancerous cells in the breast, thereby reducing the cardiac morbidity due to treatment.
The Center for Advanced Radiation Oncology at the Shady Grove Aquilino Cancer Center recently installed the latest in radiation therapy technology with a new Varian Trubeam linear accelerator which employs these technologic advances:
- Deep inspiration breath-hold (DIBH)
- During inspiration, the lungs expand which pulls the heart away from the breast or chest wall. Patients hold their breath intermittently during treatment to allow treatment delivery. Studies have shown a significant decrease in radiation dose to the heart with this technique.
- IDENTIFY system/Six-degree couch
- This allows more accurate delivery of the radiation beam to allow sparing of normal tissues as well as facilitates the DIBH technique. This system has an additional benefit that tattoos are no longer required for treatment.
- Lying prone for treatment
- When treating only the breast, the prone position allows the breast to fall away from the chest wall, thereby delivering radiation to the cancer while limiting exposure to the heart.
“It is very exciting to have this new technology so that we can continue to provide the very best cancer care to patients in this area,” said Dr. Bhooshan.
Your radiation oncology team will assist with identifying the best treatment technique for your case.
While there are potential risks to receiving radiation treatment to the breast, the benefits of radiation treatment in reducing recurrence and improving survival frequently outweighs these risks. Ask your medical team to review all options and associated risks to better understand your treatment. Together, you will be able to work together and make decisions that are right for you.
