Avoiding the heart : about optimising whole breast irradiation

Mast, M.E. (2015)

Doctoral Thesis

Preclinical and clinical studies reveal that left-sided breast cancer radiotherapy is associated with an increased rate of major coronary events. Consequently, when irradiating women with left-sided breast cancer, specific measures should be taken to decrease the heart dose as much as possible and to avoid radiation-induced coronary artery disease. This thesis focuses on several strategies to optimise the radiation treatment for patients with left-sided breast cancer. With respect to whole breast irradiation we concluded that: __ the routine use of MR images in addition to the CT scan, when delineating either the glandular breast tissue or the lumpectomy cavity, does not have added value. __ tangential IMRT technique combined with a breath-hold technique should be the treatment technique of choice for left-sided breast cancer. __ a breath-hold technique should and can be used in all left-sided breast cancer patients, regardless of age and breast size. __ breath-hold in left-sided whole breast radiotherapy results in a less pronounced increase of coronary calcium score and, hence, could result in less radiation-induced cardio vascular damage.

• Calciumscore
• MR
• CT
• IMRT
• Breath-hold
• Heart sparing
• Breast cancer
• Radiotherapy

• All authors: Mast, M.E.
• Supervisor: Struikmans, H.
• Co-supervisor: Petoukhova, A.L.; Scholten, A.N.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine (LUMC), Leiden University
• Date: 2015-06-06
• ISBN (print): 9789082241518