Left breast radiation - prone or no?

Susiemommy

I've read that radiation in the prone position is safer for surrounding healthy tissues - especially for the left breast. I asked about prone positioning at my consult, and my RO just said that they didn't offer it. I wish I would have had the presence of mind to press further and ask if I should seek it elsewhere, but I just dropped it and sort of moved on. I have this little treatment hiatus due to my port removal surgery next week, so I haven't been mapped yet. I've since learned that it (radiation in the prone position), in fact, IS offered right here in town - just at a "competing" hospital. So, now I have a new patient appointment set up with an RO there. Does anyone have any experience with or knowledge about this? Is it really that much better/safer? Is it worth it to step outside of my established team of doctors to do it? I have to be honest, heart damage has been one of my biggest fears from any of the treatments so far. I'm so exhausted from trying to ferret out information on one treatment or another on the internet, I would appreciate any info you all could give me here. Thanks!

ctmbsikia

Hi. I'm not sure why some places do not offer the prone position, but others do. It seems to me if you are worried about, I would go to prone. Even though it's another center, you can possibly be released after 1 follow up visit after treatment. Good for you for looking into it!!

My 1st mapping failed doing the breath hold, and it was ME who asked if we can try a different position instead of sending me to re mapping again. The RO agreed and I was treated in the prone position. Just my experience but laying on a metal plate instead of holding my breath felt safer to me.

Best wishes to you.

Susiemommy

Thanks for the info, ctmbsikia. So, how does mapping fail? I know so little about this. Did you happen to ask your RO why they didn't suggest the prone position in the first place? I'm just wondering if there are drawbacks that I'm just not thinking of or finding anywhere...or if some people just aren't candidates for it.

Spookiesmom

The first time I did rads was on the left side. On my back. Supine position? I did ask that RO about heart damage, he said they could stop the beam before it got to my heart. This was 8 years or so ago, nothing was said about holding my breath. The second time with rads was on the right side. Same facility same techs. Different RO, no problem. I don’t have any heart issues that I didn’t already have.

ctmbsikia

Sussie, after they do a mapping they take you through a simulation with the machine not actually on. If everything lines up as planned, then they turn the machine on. Doing the breath hold the beam was going too far over and hitting my right breast and that's what they didn't like, so we re did it by going prone.

Anyway, I didn't really dig, but I did find this abstract and it says that either way, your heart should be fine. But again, no harm in challenging and asking questions.

https://pubmed.ncbi.nlm.nih.gov/31912595/

justducky1

I was offered radiation in the prone position because my tumor was very low and to the left in my left breast. I knew I wanted this because I was concerned about heart damage and possible lung damage. By having my breast irradiated in this way (breast is isolated dropping through an opening in the table) the radiation goes through the breast and not through the heart. I think this the way to go to lessen any collateral damage. It's pretty easy and does not require respiratory gating. My breast is treated from left to right and then another set of rays up to down. I think the entire thing takes less than 10 mins, not counting positioning which has to be exact. If you have any questions please ask away