The Role of Active Breathing Control-Moderate Deep Inspiration Breath-Hold (ABC-mDIBH) Usage in non-Mastectomized Left-sided Breast Cancer Radiotherapy: A Dosimetric Evaluation

The aim of this study is to evaluate the dosimetric impact of utilizing Active Breathing Control-moderate deep inspiration breath-hold (ABC-mDIBH) technique in early-stage left-sided breast cancer radiotherapy (RT). Twenty-five patients with left-sided early-stage breast cancer undergoing breast-conserving surgery referred to our department for adjuvant radiotherapy between October 2010 and October 2011 were scanned with computed tomography (CT)-simulator at free breathing (FB) and ABC-mDIBH for radiation treatment planning. Two separate treatment plans were generated for each patient, with and without ABC-mDIBH to comparatively evaluate dose-volume parameters of both plans. Dose-volume parameters of lung, heart, left anterior descending artery (LAD), contralateral breast and spinal cord were significantly reduced with ABC-mDIBH compared to free breathing (p< 0.001). The use of ABC-mDIBH technique in the practice of early-stage left-sided breast cancer radiotherapy improves critical organ sparing with the dosimetrically-confirmed potential to decrease treatment-related morbidity and mortality. This respiratory management strategy is a promising tool that may be routinely used for the treatment of patients with early-stage left-sided breast cancer.