Treatment of breast cancer is multidisciplinary and multimodal and in optimal cases, centralised in centres of comprehensive cancer care. The management is based on surgery, hormone therapy, chemotherapy, biological therapy, and radiation therapy. With long life expectancy in patients with early stages of breast cancer, late and very late toxicity of treatment are becoming the key factors in the selection of individual modalities.
According to published results, proton radiotherapy is the leader in terms of compliance with the requirements for dose reduction for both critical organs (heart and lungs). Furthermore, it reduces the risk of secondary malignancies due to a significant reduction in the integral dose.
Indications for Proton Radiotherapy
At the Proton Therapy Center in Prague, breast cancer is treated only following surgery.
In view of the preceding information, good candidates for proton beam treatment are young patients with left-side breast cancer, where it is necessary to reduce the cardiotoxicity and pneumotoxicity. Another possible group consists of patients with pre-existing cardiac disease, where radiotherapy may lead to significant worsening of the existing heart disease.
The benefits of using proton therapy over photon radiotherapy for right breast are lower, compared to left breast. This is because for left breast, thanks to the physical properties of protons, it is possible to spare the heart and lung from receiving an excess dose of radiation. For right breast, it is possible to spare the lung from receiving an excess dose of radiation.
- Metastasis (the cancer has spread from its primary location to other organs)
- Metal/ceramic parts in the radiation field
- Presence of a pacemaker
Advantages of Proton Therapy
Sparing the high-risk organs with excellent coverage of the target volume, proven by dosimetric analysis, are the main benefits of proton radiotherapy. A study conducted at the Memorial Sloan-Kettering Cancer Centre in New York showed that postoperative proton radiotherapy is well tolerated, with acceptable acute dermal toxicity in a group of female patients with non-metastatic breast cancer, with excellent coverage of the target volume including the internal mammary nodes. The integral dose to risk organs (heart, lung and contralateral breast) were significantly lower than the ones expected from conventional photon radiation therapy.
Patients whose tumour position changes due to respiratory movements are irradiated using a controlled breathing method called Deep Inspiration Breath Hold (DIBH). Click here to learn how this breathing method works.
To learn more about proton therapy for breast cancer, or to find out if you are a suitable candidate for treatment at our centre, contact us today. Our team will get back to you with a detailed response as soon as possible.
* Suitability for treatment at our centre must be determined by our medical team.