Breast cancer is one of the most common cancers among women. The standard treatment includes mastectomy or breast conservation surgery followed by adjuvant breast radiation therapy. Adjuvant breast cancer radiotherapy reduces the risk of cancer recurrence and death but usually involves some radiation of the heart, especially for left-sided breast patients. Several technical approaches such as optimization of beam angles, treatment in prone position and deep inspiration breath hold have been already implemented to minimize the heart dose rate. However, not all patients are eligible for such techniques because of other comorbidities.
Joseph et al. investigated the cardiac-sparing effect when using an Orfit thermoplastic breast mask for left-sided breast patients that are ineligible for breath-hold techniques during radiation therapy treatment. Plans of free-breathing patients without thermoplastic mask were compared to plans of patients immobilized with the arms extended over the head on the AIO base plate using an Orfit 6-points Thorax & Abdomen Mask (33724/32MA).
Study results revealed that customized breast masks produced a significant reduction in the doses to and volumes of heart, left ventricle, and lung compared with free-breathing patients without thermoplastic mask. Hence, customized thermoplastic breast masks could be used as a cardiac-dose-sparing alternative for patients who are ineligible for a breath-hold technique or at cancer centers without a facility for conformal radiation techniques or breath-hold capability.
Patient with right breast positioning shell. A hole is cut at the location of the nipple and nipple position aligned with laser and field marks on the shell.
