title: Internal mammary lymph node irradiation contributes to heart dose in breast cancer.
abstract: We assessed the impact of internal mammary chain radiotherapy (IMC RT) to the radiation dose received by the heart in terms of heart dose-volume histogram (DVH). Thirty-six consecutive breast cancer patients presenting with indications for IMC RT were enrolled in a prospective study. The IMC was treated by a standard conformal RT technique (50 Gy). For each patient, a cardiac DVH was generated by taking into account the sole contribution of IMC RT. Cardiac HDV were compared according to breast cancer laterality and the type of previous surgical procedure, simple mastectomy or breast conservative therapy (BCT). The contribution of IMC RT to the heart dose was significantly greater for patients with left-sided versus right-sided tumors (13.8% and 12.8% for left-sided tumors versus 3.9% and 4.2% for right-sided tumors in the BCT group and the mastectomy group, respectively; p < 0.0001). There was no statistically significant difference in IMC contribution depending on the initial surgical procedure. IMC RT contributes to cardiac dose for both left-sided and right-sided breast cancers, although the relative contribution is greater in patients with left-sided tumors.
authors.affiliation: Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Pierre
authors.initials: P
authors.lastname: Castadot
authors.forename: Dhara
authors.initials: D
authors.lastname: Macdermed
authors.forename: Christophe
authors.initials: C
authors.lastname: Vandekerkhove
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bourgois
authors.forename: Paul
authors.initials: P
authors.lastname: Van Houtte
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006321:Heart / Q000528:radiation effects*; D006801:Humans; D015182:Lymphatic Irradiation / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies; D011874:Radiometry