Heart-saving techniques during breast cancer treatment


Assal Rahimi, M.D., with the Cyberknife.

Breast cancer is being treated with more success than ever before. But some of the therapies that can cure cancer, such as radiation, come with a small risk of the survivor developing heart complications later on, particularly in those with left-sided breast cancer.

Let’s take a look at how radiation can affect the heart, and what your doctor can do to help reduce your risk.

How can radiation therapy affect the heart?

Heart complications from cancer treatment are rare, and often exist unbeknownst to the patient before cancer treatment begins. However, these conditions can occur:

  • High blood pressure
  • Abnormal heart rhythm (arrhythmia)
  • Weakening of the heart muscle (cardiomyopathy)

In more serious cases, heart attack, stroke, or heart failure can occur. As mentioned, these complications are rare. That said, we have a team of onco-cardiologists who work together to make sure our patients risk is as low as possible while effectively treating the cancer.

Decreasing heart risks from radiation

One solution to reducing radiation exposure to the heart may be as simple as having patients strategically hold their breath during radiation treatment. The deep inspiration breath hold is a cardiac-sparing or -minimizing technique that has shown great promise in reducing long-term side effects in left-sided breast cancer patients. Taking a deep breath and holding it during treatment causes the chest wall and breast tissue to move away from the heart, reducing the radiation dose to the heart and lungs.

Another solution is the use of high-tech video surveillance. UT Southwestern was the first institution in Texas to implement this method to further improve the deep inspiration breath-hold technique. The video system (VisionRT) uses two ceiling-mounted 3-D cameras to beam a patterned light grid onto the patient. The system tracks the external contours of the breast area and matches it to the patient’s initial CT scan. It is a completely noninvasive approach that allows the physician to verify the target location and deliver radiation safely, without assisted breathing devices, markers, or additional X-ray exposure.

A typical treatment takes a total of 60 to 120 seconds – that’s two to four deep breath holds for 30 seconds each.

Compared with free breathing, the breath-hold technique using the 3-D system can yield as much as a fourfold decrease in the total mean radiation dose to the heart. The technique has also proven to reduce the radiation dose to the left anterior descending artery in the heart, a common site of atherosclerosis leading to coronary heart disease.

The deep inspiration breath hold performed with high-tech surveillance can be a very important technique for patients who need to have left-sided whole breast radiation, and as pioneers in the use of this technology, we are pleased to offer it to patients.

Concerned about your risk for heart complications during cancer treatment? Request an appointment to discuss your questions with a doctor.