Looking Down on Breast Cancer

Prone position provides another way for some women to receive breast radiotherapy.

Radiation therapy plays an integral role in the treatment plan for many breast cancer patients, reducing cancer recurrence and improving survival. Radiation is used following breast conserving surgery and sometimes after mastectomy. Side effects may include fatigue and skin changes and long-term treatments can affect the ribs, lungs, heart and pose a small risk for a secondary cancer.

What is prone breast radiation therapy?
Prone breast radiation refers to an alternate way to position the patient during therapy. The patient lies face down on a specially designed device called the prone breast board, which allows the breast being treated to hang forward away from the chest wall.

Which patients are candidates for prone breast radiation?
Prone positioning may be used in early stage breast cancer patients where the target for treatment is the breast only. Prone is not an appropriate option for all women, including those who have undergone mastectomy or require nodal radiation or in whom the chest wall needs to be fully treated. Prone positioning also requires patients to have the mobility to climb on the treatment table and be able to lie on their belly for 20 to 30 minutes.

What are the potential benefits?
Thanks to gravity, the breast falls away from the chest wall, minimizing tumor movement during breathing and reducing the radiation dose received by normal tissues. This can mean:

  • Reduced risk of side effects to the heart and lungs
  • Fewer skin-related side effects, particularly in larger-breasted women
  • Better dose distribution throughout the breast and fewer “hot spots,” or uneven radiation

How will I know if prone is right for me?
We assess all patients to determine how best to deliver their radiation, including the appropriate treatment position and technique to minimize unwanted side effects. There are other techniques available to minimize radiation dose to normal tissues, such as “respiratory gating,” which means treatment is given while a patient is holding her/his breath.