The Prone Breast Technique For Breast Cancer Patients

By Kathleen Settle, MD

Chesapeake Potomac Regional Cancer Center

. http://www.chesapeakepotomaccancer.com/

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The Prone Breast Technique For Breast Cancer Patients

When diagnosed with breast cancer, many women are given the options of preserving their breast, by just removing the cancerous tissue, or having their breast removed, known as a mastectomy. The majority of women who choose to undergo breast conservation/preservation will require post-operative radiation therapy. Radiation therapy involves treating the entire breast with invisible and painless high energy X-ray beams for 3.5-6.5 weeks. Side effects include mild fatigue and a skin reaction mimicking sun exposure and worst-case scenario, a sun burn. Depending on the patient's anatomy, a small amount of lung or heart (if treating the left breast) is exposed to the X-ray beam. Fortunately, long-term complication rates from radiation therapy are extremely low.

Historically, all breast cancer patients have been treated while positioned on their back (“supine”), typically on an angled board, with the arm on the side of the cancer elevated above their head. The prone breast technique involves positioning a patient face down (“prone”) on a special board, which allows their involved breast to hang down. Research has shown that the prone position may be beneficial for some woman with breast cancer by reducing the severity of skin burns and after treatment swelling of the breast. These women are generally patients with very large and/or pendulous breasts. Studies also demonstrate that the prone position may reduce the lung and heart's exposure to the X-ray beams.

However, not everyone is a candidate for the prone position. Classic examples would include patients unable to tolerate lying on their stomach for 10-20 minutes, cancers located close to the left chest wall, patients requiring treatment of both their breast and lymph node regions, or patients with a body shape resulting in more heart or lung being exposed in the prone position versus the supine.

If you have been diagnosed with breast cancer, we encourage you to see a radiation oncologist for an initial consultation prior to making any surgical decisions as this is the standard practice at the university hospitals in Washington, DC, such as Georgetown, and Baltimore, such as The University of Maryland and Johns Hopkins. The potential role of radiation therapy in the treatment of your breast cancer may influence your surgical decision (i.e. lumpectomy versus mastectomy). Therefore, having all available information will only aid in a patient making the best decision for them.