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Respiratory maneuvers decrease irradiated cardiac volume in patients with left-sided breast cancer.

Ming Hui Chen¹, Ethan P Cash, Peter G Danias

¹Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. mhchen@partners.org

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance

|June 21, 2002

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Deep inspiration breath holds significantly reduce heart radiation exposure in left breast cancer patients. This technique minimizes cardiac volume within radiation portals, potentially lowering cardiovascular toxicity for survivors.

Area of Science:

Oncology
Radiotherapy
Cardiology

Background:

Late cardiac morbidity and mortality in left breast cancer survivors are linked to radiation portal cardiac volume.
Reducing cardiac exposure during radiation therapy is crucial for improving long-term outcomes.

Purpose of the Study:

To evaluate the efficacy of respiratory maneuvers in decreasing cardiac volume within radiation portals for left-sided breast cancer patients.
To assess the impact of deep inspiration breath holds on reducing heart exposure during radiotherapy.

Main Methods:

Cardiac magnetic resonance imaging (MRI) was performed on 17 women with left breast cancer.
Cardiac volume within radiation portals was measured during breath holding at end-tidal volume (ETid) and deep inspiration.
Comparison of irradiated cardiac volumes between the two breathing techniques.

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Main Results:

14 subjects (93%) had heart volume within radiation portals at ETid (median 25.9 cm3).
Inspiratory breath holding significantly decreased irradiated cardiac volume (median change -18.1 cm3, -49%, p < 0.001).
Deep inspiration allowed complete displacement of the heart outside the radiation field in 21% of patients.

Conclusions:

Deep inspiratory maneuvers significantly reduce cardiac volume within the left breast radiation field.
This technique preserves radiation dosage to the breast while minimizing cardiac involvement.
Respiratory maneuvers offer a strategy to reduce cardiovascular toxicity in breast cancer patients undergoing radiation therapy.