Radiotherapy is a vital component in the treatment of breast cancer. In many settings, radiotherapy reduces the risk of cancer recurrence and improves survival from breast cancer. However, radiotherapy can also cause damage to the normal tissues, most notably the heart. Northwestern Medicine sets very tight constraints on the amount of dose that we allow to reach your heart using several important techniques.

Deep Inspiratory Breath-Hold (DIBH) is one valuable technique used to minimize radiation dose to the heart. For some patients, taking in a deep breath moves the heart down and back, away from the radiotherapy field. In DIBH, the following scans are taken:

• Free breathing
• Deep inspiration

Two radiotherapy plans are created and compared, and the optimal one is used in treatment.

Patients who benefit from DIBH, receive radiotherapy to the breast, while taking a deep breath. We carefully monitor the extent of the deep breath, and the radiation beam automatically shuts off if the patient breathes out. This way, the treatment is always delivered with precision.

These images show three slices taken through the breast at both free breathing (left) and deep inspiration (right), with the red line representing the edge radiotherapy field. It's clear that the use of DIBH helped this patient spare their heart from excessive exposure to treatment.