Deep inspiration breath hold (DIBH) is a simple technique used during treatment of the breast or chest wall cancers and decreases the potential radiation dose to the heart.
In the past, the machines used to treat breast cancer were not advanced enough to reduce radiation dose or avoid the heart. Because of this, left-sided breast cancer treatments delivered in earlier may have given radiation to the front part of the heart, which has been associated with an increase in cardiovascular disease.
Today, we utilize advanced radiation technology, such as surface-guided radiation therapy (SGRT) alongside DIBH to allow us to precisely target the area at risk for residual cancer cells, while at the same time, reduce the radiation dose to the heart.
During a deep breath, the heart naturally moves away from the front part of the chest. With DIBH, you are instructed to hold your breath at certain moments during treatment or may be offered a device to help control your breathing while radiation is administered. These techniques will move your heart further away from the treatment area.
While you are holding your breath and your breast area is in the right position, the radiation machine begins to deliver the treatment. Because the surface-guidance technology tracks both your body and the treatment location, it can detect any motion as you hold your breath and turn the treatment machine off if you breathe out or move.
Studies have shown that the DIBH technique can reduce the mean dose of radiation to the heart compared to breathing normally,1-3 with one recent study indicating it can reduce the mean dose to the heart by 39%.4
DIBH is performed while you are lying on your back. If you are unable to hold your breath or lie on your back, lying on your stomach may be another option. This is called prone positioning.
With prone positioning, you lie on your stomach to receive treatment with a board resting beneath your head and stomach, leaving a gap of space in the breast region. This technique uses gravity to move the breast tissue away from the chest wall.
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