In order to choose the optimal treatment, it is important to receive comprehensive and comprehensible information. If radiotherapy has been recommended to you, ask your treating oncologist about all the available irradiation methods as well as treatment-related side effects. These may significantly affect the quality of your life during and after treatment. Our physicians have many years of experience in radiotherapy. Moreover, they are experienced in both standard (photon) and proton radiation therapy and are prepared to answer all of your questions.
Multiple therapies are often combined in breast cancer treatment. The therapies include surgery, chemotherapy, hormonal therapy, biological therapy and radiotherapy. 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 typically treated following surgery.
In view of the preceding information, good candidates for proton beam treatment are patients with left-side or bilateral 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.
One substantial reason to choose proton radiotherapy for breast cancer would be radiation induced heart disease (RIHD). Heart disease caused by radiation is one of the most serious and best-documented very late effects of radiation. Therefore, in the treatment of breast cancer, when radiation is recommended, experts seek to minimise the radiation dose to the heart. Thanks to the proton beam, we are able to significantly reduce the risk of the occurrence of cardiac infarction, cardiac complaints, or the risk of development of pulmonary fibrosis.
Contraindications
- Metastasis (the cancer has spread from its primary location to other organs) – lymph nodes involvement is typically not a contraindication
- 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 organs at risk (heart, lung and contralateral breast) were significantly lower than the ones expected from conventional photon radiation therapy.
A study conducted by a team of physicians from MGH in Boston showed that proton radiotherapy of breast cancer especially in patients with necessary radiation of sentinel lymph nodes has a low toxicity while maintaining the same control over cancer as previously published photon radiotherapy data.
Patients whose tumour position changes due to respiratory movements are irradiated using a controlled breathing method called Deep Inspiration Breath Hold (DIBH). This allows us to irradiate the tumour consistently during each treatment session, ensuring safety and precision. 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.