Prone Position Provides a Safer Option for Radiation Therapy for Breast Cancer

Published: Wednesday, December 14, 2016

wns grace dixon

Grace Dixon, MD

The Edwards Comprehensive Cancer Center at Cabell Huntington Hospital makes patient safety a priority by continually studying and researching options for the best breast cancer treatments possible. Recent studies have shown that lying face down (also called "prone") to receive radiation therapy to the breast area reduces the amount of radiation that unintentionally reaches the heart and lungs.

"When lying face up to receive radiation treatment for breast cancer, the risk increases of exposing radiation to major internal organs," said Grace Dixon, MD, radiation oncologist at the Edwards Comprehensive Cancer Center. "The heart is especially vulnerable when treating the left breast as it is directly in line with the heart."

Dixon said that by placing the patient in the prone position, using a specially-designed table with a breast board for comfort, the breast drops away from the body allowing better isolation of the area for treatment. And with the breast away from the body, surrounding organs such as the heart and lungs are less likely to receive radiation exposure which lowers the risk of complications such as future heart disease and lung damage. Prone positioning also improves dose homogeneity, leading to a more tolerable treatment course and better cosmetic outcomes. This is especially true in large-breasted women.

"This is much safer for the patient and is more precise in delivering radiation," said Dixon. "When a woman lies on her back, gravity pulls the breast closer to the body. And because larger breasts may lay flat differently with each session, the radiation precision can vary."

Dixon said the prone position ensures radiation is distributed evenly, consistently and accurately with each treatment. In addition to patient positioning, advances in radiation therapy have also minimized the amount of exposure to the heart, lungs and other healthy tissue. Using advanced equipment physicians are able to deliver higher radiation doses to breast cancer cells while limiting damage to healthy tissue.

Advantages of using the prone position for treatment include:

  • reducing the amount of heart tissue exposed to radiation by 86%
  • reducing the amount of lung tissue exposed to radiation by 91%

"While these reductions sound large, it's important to remember that only a very small area of the heart and lungs might be exposed to radiation while lying face up. But because we want to eliminate any over exposure we can, this is the best solution to minimize the risks," said Dixon.