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Hold Your Breath and Spare Your Heart

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Breathing Technique Reduces Radiation to the Heart During Breast Cancer Treatments

July 19, 2017 — “Take a deep breath and hold it.” With that simple instruction, The Department of Radiation Oncology at Valley-Mount Sinai Comprehensive Cancer Care is helping patients with breast cancer protect their heart health.

Called Deep Inspiration Breath Hold (DIBH), the technique uses a woman’s breathing patterns to limit radiation exposure to the heart.

Studies have shown that even low doses of radiation during breast cancer treatment can damage the heart. This risk is particularly high for women who receive radiation to the left breast.

“As you take a deep breath in, your lung expands, moving the breast up away from the heart while also pushing the heart backwards away from the chest wall and the treatment field,” explains Chad DeYoung, M.D., Co-Director of Radiation Oncology at Valley. “This can displace the heart by as much as a couple of centimeters, which might sound like a small shift, but can actually make a big difference in sparing the heart from receiving direct radiation.”

In fact, DIBH can cut the average dose of radiation to the heart by 26.2 to 75 percent, according to a recent analysis published in the Journal of Medical Radiation Sciences.

The technique relies on real-time monitoring to ensure that the radiation therapy is delivered at the optimal time. Sensors on the patient’s chest monitor the displacement of the chest as a deep breath is taken. This information is then used to deliver the treatment accurately and at the optimal time using a TrueBeam linear accelerator.

The technology’s real-time monitoring capabilities give radiation oncologists the ability to know the position of the breast during a patient’s breathing and deliver treatment at the precise time when radiation to the heart will be at its lowest point. If there is too much or too little air in the patient’s lungs, the radiation treatment will not be delivered.

“The DIBH procedure enables us to provide appropriate breast cancer patients with highly targeted radiation treatments. This is crucial because it protects the patient’s heart by ensuring that it receives minimal radiation during treatment,” adds Michael Wesson, M.D., Co-Director of Radiation Oncology at Valley.

To bring our patients the most up-to-date care and leading-edge clinical research in oncology, Valley Health System has partnered with the Mount Sinai Health System. Drs. DeYoung and Wesson both hold appointments as Clinical Assistant Professors at the Icahn School of Medicine at Mount Sinai and have been selected by their peers as a Castle Connolly Top Doctor for 2017.

For more information on this procedure, please call 201-634-5403.

Caption: The Department of Radiation Oncology at Valley-Mount Sinai Comprehensive Cancer Care has incorporated a technique called deep inspiration breath hold to help patients with breast cancer protect their heart health during radiation treatments. Shown here (left to right) are: Chad DeYoung, M.D., Co-Director of Radiation Oncology; radiation oncologist Thomas Kole, M.D.; and Michael Wesson, M.D., Co-Director of Radiation Oncology.

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