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Breast cancer has a very high incidence. If you look at the ‘2019 National Cancer Registration Project Annual Report’, breast cancer is the most common cancer after thyroid cancer in women. Fortunately, it is a cancer with a high survival rate, with a 5-year survival rate of 93.6% from 2015 to 2019.

As the survival rate is high and the survival period is long, interest in the quality of life of patients after breast cancer treatment is growing. Among these, the biggest concern for patients is cardiovascular disease.

The standard treatment for breast cancer is surgery and radiation therapy, and radiation therapy is essential to prevent recurrence after surgery. Radiation therapy has many advantages because it is non-invasive and has few side effects and complications.

According to the research team of the Department of Cardiology at Hallym University Dongtan Sacred Heart Hospital, the incidence of cardiovascular disease reached 17% in the high-risk group after 7 years of breast cancer treatment. Radiation therapy to the left breast is a major risk factor affecting the occurrence of cardiovascular disease. This is because there is a high possibility that nearby major coronary arteries will be exposed to radiation during radiation treatment of the left breast where the heart is located.

According to a famous paper, ‘Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer’, published in The NEW ENGLAND JOURNAL of MEDICNE in 2013, The incidence of coronary artery disease increased by 7.4% for every 1Gy increase in radiation dose delivered to the heart.

In the midst of this, Hallym University Dongtan Sacred Heart Hospital (Hospital Director Lee Seong-ho) is implementing radiation therapy to lower the probability of heart disease during radiation therapy for left breast cancer.

The Department of Radiation Oncology at Hallym University Dongtan Sacred Heart Hospital is performing Breath Holding radiation therapy to minimize the amount of radiation entering the heart during left breast radiation therapy.

In this treatment, patients undergoing radiation therapy on the left breast are treated while holding their breath while inhaling. When you breathe in, the lungs expand and the diaphragm descends, moving the irradiated area away from the heart.

When receiving radiation therapy, the actual irradiation time is about 30 to 40 seconds, and if the radiation is irradiated in 10-second intervals, it is possible for the patient to receive treatment while holding his breath.

For accurate radiation irradiation, a surface-guided radiation therapy technique using ‘Align RT’, a radiation therapy auxiliary device from Vision RT, is used.

During the pre-radiation simulation treatment, the patient inhales and holds the breath, takes a CT scan, and designs the radiation treatment. Then, in the treatment room, Align RT identifies the movement of the patient’s body surface in real time and performs radiation treatment. During the pre-CT scan, if the posture error is large compared to the patient’s body surface, the treatment is automatically stopped, and the patient’s posture error can be checked in increments of 0.1 mm. With this surface-guided radiation therapy technique, radiation can be irradiated avoiding the heart after calculating the exact position and angle when the patient holds and holds their breath.

This treatment takes a lot of time and requires a lot of effort from the medical staff because you have to hold your breath, take a radiation simulation CT, and keep the patient’s posture during treatment. The average radiation treatment time is 5 minutes, but the breath holding radiation treatment takes 10 to 15 minutes, 2 to 3 times longer than this.

Professor Ha Bo-ram of the Department of Radiation Oncology said, “Despite the development of modern radiation treatment technology, due to the anatomical location of the heart, low-dose radiation is still being irradiated to the heart during radiotherapy for left breast cancer, raising concerns about cardiovascular disease.” In the case of patients, the survival period is long and cardiovascular disease can appear even after 15 to 20 years, so breath-holding therapy is being implemented for all left breast cancer patients to improve the quality of life of patients.”

Reporter Jang Jong-ho bellho@sportschosun.com