Face-down position may be safer during radiation for breast cancer: study

September 6, 2012 by Kathleen Doheny, Healthday Reporter
Face-down position may be safer during radiation for breast cancer: study
Findings suggest prone position might reduce exposure of heart, lungs.

(HealthDay)—Changing the position of a patient while receiving radiation therapy for breast cancer may reduce the later risks of heart and lung problems, according to a new study.

patients who get after breast-conserving surgery typically are placed in a supine, or face-up, position, said study leader Dr. Silvia Formenti, chairwoman of the department of radiation oncology and associate director of the NYU Cancer Institute at the New York University School of Medicine and Langone Medical Center in New York City.

Her new study, which included 400 patients, suggested the prone, or face-down, position may be better for most.

"Radiation oncology centers should develop the expertise to treat prone," she said. The study was published as a research letter Sept. 5 in the .

Of the 400 in the study, half had cancer in the right breast and half in the left breast. Most of the women (nearly 79 percent) had . Of those, about 15 percent had lymph node involvement. The average age was about 56.

All the women had two CT simulation scans, first supine and then prone.

Simulation scans are used to help doctors visualize structures such as the and lungs and help them make a plan about the best treatment position to target the cancer effectively while sparing normal tissue as much as possible. Formenti compared how well each position would spare the heart and from radiation.

She found for all patients that the prone position was linked to less exposure of the lungs than the supine position. In those with cancer of the left breast, the prone position was linked to a reduced exposure to the heart.

Formenti found, however, that in 15 percent of women with cancer of the left breast, supine positioning was better.

"The minority better off in supine position (15 percent in our study) was more likely to have a very small breast," Formenti said.

" should first be simulated prone," she said. "If some of the heart is in the field [to be irradiated] when prone ... they should then be simulated supine to see whether they are better off in the standard supine position."

Dr. Nayana Vora, clinical professor of radiation oncology at the City of Hope Comprehensive Cancer Center in Duarte, Calif., agreed somewhat with the conclusions.

"I think in selected cases this is a good idea," she said, such as if the cancer has not spread to the lymph nodes. She said treatment planning is done first, to decide which position is best for each patient.

"The majority of our [patients] still get supine," she said. "It is more comfortable for patients."

It is possible to block the irradiation to the heart and other structures by using a shield-like device, she said.

"In selected cases we do prone," she said, but some women are not comfortable in this position. Although each session is only about 10 minutes, women usually undergo treatment for about six weeks, she said.

"Personal comfort has to be taken into account," she said, but never at the expense of risks to the heart and lungs.

The authors noted that their study was limited to a single institution and a multi-institutional study would be needed to confirm the findings.

Explore further: Accelerated radiation treatment effective for noninvasive breast cancer

More information: The Radiological Society of North America and American College of Radiology have more about simulation in external beam radiation treatment.

Related Stories

Accelerated radiation treatment effective for noninvasive breast cancer

June 29, 2012
Accelerated whole breast irradiation after lumpectomy is an effective treatment for ductal carcinoma in situ (DCIS), a very common early stage and noninvasive form of breast cancer, meaning many more breast cancer patients ...

Breast cancer surgery patients benefit from adding radiation therapy

June 4, 2011
Additional radiation treatment improves disease free survival lessening the chance of cancer recurring in women with early breast cancer who have had breast conserving surgery (lumpectomy), interim results of a new study ...

Radiation after lumpectomy helps prevent need for mastectomy in early stage breast cancer

August 13, 2012
Contrary to clinical recommendations, older women with early stage breast cancer may want to undergo radiation after lumpectomy to help ensure that they will not need a mastectomy in the future. That is the conclusion of ...

Recommended for you

Lung cancer triggers pulmonary hypertension

November 17, 2017
Shortness of breath and respiratory distress often increase the suffering of advanced-stage lung cancer patients. These symptoms can be triggered by pulmonary hypertension, as scientists at the Max Planck Institute for Heart ...

Researchers discover an Achilles heel in a lethal leukemia

November 16, 2017
Researchers have discovered how a linkage between two proteins in acute myeloid leukemia enables cancer cells to resist chemotherapy and showed that disrupting the linkage could render the cells vulnerable to treatment. St. ...

Computer program finds new uses for old drugs

November 16, 2017
Researchers at the Case Comprehensive Cancer Center at Case Western Reserve University School of Medicine have developed a computer program to find new indications for old drugs. The computer program, called DrugPredict, ...

Pharmacoscopy improves therapy for relapsed blood cancer in a first clinical trial

November 16, 2017
Researchers at CeMM and the Medical University of Vienna presented a preliminary report in The Lancet Hematology on the clinical impact of an integrated ex vivo approach called pharmacoscopy. The procedures measure single-cell ...

Wider sampling of tumor tissues may guide drug choice, improve outcomes

November 15, 2017
A new study focused on describing genetic variations within a primary tumor, differences between the primary and a metastatic branch of that tumor, and additional diversity found in tumor DNA in the blood stream could help ...

A new strategy for prevention of liver cancer development

November 14, 2017
Primary liver cancer is now the second leading cause of cancer-related death worldwide, and its incidences and mortality are increasing rapidly in the United Stated. In late stages of the malignancy, there are no effective ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.