Have a personal or library account? Click to login
Dosimetric Outcomes of Deep Inspiration Breath-Hold (DIBH) Technique in Terms of Normal Tissue Sparing for Right-Sided Breast Cancer Irradiation: A Single-Institution Experience Cover

Dosimetric Outcomes of Deep Inspiration Breath-Hold (DIBH) Technique in Terms of Normal Tissue Sparing for Right-Sided Breast Cancer Irradiation: A Single-Institution Experience

Open Access
|Oct 2025

References

  1. Kwong DL, McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M, Gray R, Mannu G, Peto R, Whelan T. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. The Lancet. 2014.
  2. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. New England Journal of Medicine. 2002 Oct 17;347(16):1233–41.
  3. Speers C, Pierce LJ. Postoperative Radiotherapy After Breast-Conserving Surgery for Early-Stage Breast Cancer: A Review. JAMA Oncol. 2016 Aug 1;2(8):1075–82. doi: 10.1001/jamaoncol.2015.5805. PMID: 27243924.
  4. Senkus-Konefka E, Jassem J. Cardiovascular effects of breast cancer radiotherapy. Cancer treatment reviews. 2007 Oct 1;33(6):578–93.
  5. Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B, Jensen MB. Risk of ischemic heart disease in women after radiotherapy for breast cancer. New England Journal of Medicine. 2013 Mar 14;368(11):987–98.
  6. Bartlett FR, Colgan RM, Carr K, Donovan EM, McNair HA, Locke I, Evans PM, Haviland JS, Yarnold JR, Kirby AM. The UK HeartSpare Study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy. Radiotherapy and Oncology. 2013 Aug 1;108(2):242–7.
  7. Swanson T, Grills IS, Ye H, Entwistle A, Teahan M, Letts N, Yan D, Duquette J, Vicini FA. Six-year experience routinely using moderate deep inspiration breath-hold for the reduction of cardiac dose in left-sided breast irradiation for patients with early-stage or locally advanced breast cancer. American journal of clinical oncology. 2013 Feb 1;36(1):24–30.
  8. Dumane VA, Saksornchai K, Zhou Y, Hong L, Powell S, Ho AY. Reduction in low-dose to normal tissue with the addition of deep inspiration breath hold (DIBH) to volumetric modulated arc therapy (VMAT) in breast cancer patients with implant reconstruction receiving regional nodal irradiation. Radiation oncology. 2018 Dec;13:1–7.
  9. Simonetto C, Eidemüller M, Gaasch A, Pazos M, Schönecker S, Reitz D, Kääb S, Braun M, Harbeck N, Niyazi M, Belka C. Does deep inspiration breath-hold prolong life? Individual risk estimates of ischaemic heart disease after breast cancer radiotherapy. Radiotherapy and Oncology. 2019 Feb 1;131:202–7.
  10. Marks LB, Bentzen SM, Deasy JO, Bradley JD, Vogelius IS, El Naqa I, Hubbs JL, Lebesque JV, Timmerman RD, Martel MK, Jackson A. Radiation dose–volume effects in the lung. International Journal of Radiation Oncology* Biology* Physics. 2010 Mar 1;76(3):S70–6.
  11. Choi J, Kim YB, Shin KH, Ahn SJ, Lee HS, Park W, Kim SS, Kim JH, Lee KC, Kim DW, Suh HS. Radiation pneumonitis in association with internal mammary node irradiation in breast cancer patients: an ancillary result from the KROG 08–06 study. Journal of Breast Cancer. 2016 Sep 1;19(3):275–82.
  12. Osman SO, Hol S, Poortmans PM, Essers M. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation. Radiotherapy and Oncology. 2014 Jul 1;112(1):17–22.
  13. Essers M, Poortmans PM, Verschueren K, Hol S, Cobben DC. Should breathing adapted radiotherapy also be applied for right-sided breast irradiation?. Acta oncologica. 2016 Apr 2;55(4):460–5
  14. Conway JL, Conroy L, Harper L, Scheifele M, Li H, Smith WL, Graham T, Phan T, Olivotto IA. Deep inspiration breath-hold produces a clinically meaningful reduction in ipsilateral lung dose during locoregional radiation therapy for some women with right-sided breast cancer. Practical radiation oncology. 2017 May 1;7(3):147–53.
  15. Borgonovo G, Paulicelli E, Daniele D, Presilla S, Richetti A, Valli M. Deep inspiration breath hold in post-operative radiotherapy for right breast cancer: a retrospective analysis. reports of practical Oncology and radiotherapy. 2022;27(4):717–23.
  16. Rice L, Harris S, Green MM, Price PM. Deep inspiration breath-hold (DIBH) technique applied in right breast radiotherapy to minimize liver radiation. BJR| case reports. 2015 May 8;1(2):20150038.
  17. http://www.rtog.org/CoreLab/ContouringAtlases/BreastCancerAtlas.aspx.
  18. International Commission on Radiation Units and Measurements. Prescribing, Recording, and Reporting Photon Beam Therapy. International Commission on Radiation Units and Measurements; 1999.
  19. Marks L.B., Yorke E.D., Jackson A., et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys. 2010;76(3 SUPPL.) doi: 10.1016/j.ijrobp.2009.07.1754.
  20. Mader T, Pace R, da Silva RT, Adam LE, Näf G, Winter CC, Aspradakis MM, Radovic M, Spyridonidis A, Hayoz S, Baumert BG. Deep inspirational breast hold (DIBH) for right breast irradiation: Improved sparing of liver and lung tissue. Clinical and Translational Radiation Oncology. 2024 Mar 1;45:100731
  21. Pandeli C, Smyth LM, David S, See AW. Dose reduction to organs at risk with deep-inspiration breath-hold during right breast radiotherapy: a treatment planning study. Radiation Oncology. 2019 Dec 10;14(1):223.
  22. Haji G, Nabizade U, Kazimov K, Guliyeva N, Isayev I. Liver dose reduction by deep inspiration breath hold technique in right-sided breast irradiation. Radiation Oncology Journal. 2019 Dec;37(4):254.
DOI: https://doi.org/10.2478/fco-2024-0016 | Journal eISSN: 1792-362X | Journal ISSN: 1792-345X
Language: English
Submitted on: Apr 24, 2025
|
Accepted on: Jul 10, 2025
|
Published on: Oct 24, 2025
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year

© 2025 Raka Banerjee, Koustav Mazumder, Poonam Ray, Amitabh Ray, Sayan Kundu, Chandrani Mallik, Bodhisattwa Dutta, Dilip Kumar Ray, published by Helenic Society of Medical Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

AHEAD OF PRINT