Prone breast irradiation for pendulous breasts

The UK HeartSpare Study (Stage IB): Randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery

“…Breath-holding techniques reduce heart doses [8][9][10][11] be as effective at heart-sparing and as reproducible as breath-holding treatment with the active breathing coordinator™ (ABC) (Elekta, Crawley, UK) [7]. Additional benefits, including shorter treatment setup times and lower implementation costs, are likely to establish this technique as the standard of care for many left-sided women in the UK.…”

“…However, there remains a group of largerbreasted women in whom the relative benefits of breath-hold versus prone positioning are unknown. Previous work has shown that, although the prone position moves the heart closer to the chest wall under gravity [8], larger breasts fall further forward, allowing for shallower tangential radiotherapy beam placement [9,10] and therefore significantly reduced cardiac doses in largerbreasted women [11].…”

The comparison of the radiation load to the heart and the left anterior descending coronary artery for various modes of radiation treatment of the breast cancer patients

“…Эти результаты сопостави-мы с данными других исследований [11,13,[15][16][17][18][19][20][21][22]. Как было продемонстрировано J. P. Chino и соавт., наибольшие дозы на сердце в положении на животе объясняются смещением сердца кпереди в среднем на 19 мм [23].…”

“…Преимущества ЛТ в этой позиции по сравнению с положением на спине -уменьшение облучаемого объема легочной ткани у всех больных и уменьшение объема сердца, подвергающегося облу-чению, в большей мере у пациенток с большим объе-мом молочных желез (≥ 1000 см 3 ) [11][12][13].…”

The Impact of Breast Volume on Lung and Heart Radiation Doses After Breast Conserving Surgery

“…The target volume generally includes the breast±chest wall (the chest wall isn't a target in T1,2 N0) and in some cases, the draining lymph nodes 2 .…”