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Deep Inspiration Breath Hold for left-sided breast cancer: experience from the patient’s perspective

Published online by Cambridge University Press:  29 June 2015

Neil Mc Parland ,
Luminita Nica ,
Jenny Soo  and
Tara Menna
Neil Mc Parland*
Affiliation:
Radiation Therapy Department, Vancouver Cancer Center, British Columbia Cancer Agency, Vancouver, BC, Canada
Luminita Nica
Affiliation:
Radiation Therapy Department, Vancouver Cancer Center, British Columbia Cancer Agency, Vancouver, BC, Canada
Jenny Soo
Affiliation:
Radiation Therapy Department, Vancouver Cancer Center, British Columbia Cancer Agency, Vancouver, BC, Canada
Tara Menna
Affiliation:
Radiation Therapy Department, Vancouver Cancer Center, British Columbia Cancer Agency, Vancouver, BC, Canada
*
Correspondence to: Neil Mc Parland, Radiation Therapy Department, Vancouver Cancer Center, 600 West 10th Avenue, V5Z 4E6, Vancouver, BC, Canada. Tel: (604) 877 6000 ext 2710; E-mail: Neilmcparland@hotmail.com
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Abstract

Introduction

The dosimetric benefits of Deep Inspiration Breath Hold (DIBH) in reducing cardiac dose are well documented, however reports on the patient’s personal experience with this technique are limited. The purpose of this research is to investigate DIBH from the patient’s perspective and to provide recommendations to further improve the patient experience.

Materials and methods

A questionnaire was used to record the patient’s comprehension of DIBH instructions and preparation for treatment. Levels of comfort, confidence and technical challenge were also recorded and an open-format question allowed patients to provide suggestions to improve the DIBH experience.

Results

The majority of patients do not find it difficult to hold their breath at the correct level during DIBH and confidence levels regarding ability to follow instructions are good. Comprehension of instructions, preparation to perform DIBH and treatment position comfort levels were universally graded positively.

Conclusion

The majority of patients reported a strong level of comprehension and preparation that allows them to confidently perform DIBH as planned. Establishment of a dedicated treatment team, consistent patient instructions, regular feedback and an opportunity to rehearse DIBH can help increase patient confidence and reduce anxiety.

Keywords

breast cancerDeep Inspiration Breath Holdpatient perspectivequestionnaire
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 3 , September 2015 , pp. 228 - 235
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Copyright
© Cambridge University Press 2015 

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References

1.Canadian Cancer Society Statistics 2013. Canadian cancer society breast cancer statistics. http://www.cancer.ca/en/cancer-information/cancer-type/breast/statistics/. Accessed on 1 December 2013.CrossRefGoogle Scholar
2.Clarke, M, Collins, R, Darby, Set al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 366: 2087–2106.Google ScholarPubMed
3.Fisher, B, Anderson, S, Bryant, Jet al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002; 347: 1233–1241.CrossRefGoogle ScholarPubMed
4.Kwa, S L, Lebesque, J V, Theuws, J Cet al. Radiation pneumonitis as a function of mean lung dose: an analysis of pooled data of 540 patients. Int J Radiat Oncol Biol Phys 1998; 42: 1–9.CrossRefGoogle ScholarPubMed
5.Borger, J, Hooning, M, Boersma, Let al. Cardiotoxic effects of tangential breast irradiation in early breast cancer patients: the role of irradiated heart volume. Int J Radiat Oncol Biol Phys 2007; 69: 1131–1138.CrossRefGoogle Scholar
6.Paszat, L, Mackillop, W, Groome, P, Schulze, K, Holoway, E. Mortality from myocardial infarction following post lumpectomy radiotherapy for breast cancer: a population-based study in Ontario, Canada. Int J Radiat Oncol Biol Phys 1999; 43: 755–761.CrossRefGoogle Scholar
7.Correa, C R, Das, I J, Litt, H Iet al. Association between tangential beam treatment parameters and cardiac abnormalities after definitive radiation treatment for left-sided breast cancer. Int J Radiat Oncol Biol Phys 2008; 72 (2): 508–516.CrossRefGoogle ScholarPubMed
8.Shapiro, C, Hardenbergh, P, Gelman, Ret al. Cardiac effects of adjuvant doxorubicin and radiation therapy in breast cancer patients. J Clin Oncol 1998; 16: 3493–3501.CrossRefGoogle ScholarPubMed
9.Pedersen, A N, Korreman, S S, Nyström, H, Specht, L. Breathing adapted radiotherapy of breast cancer: reduction of cardiac and pulmonary doses using voluntary inspiration breath-hold. Radiother Oncol 2004; 72: 53–60.CrossRefGoogle ScholarPubMed
10.Vikstrom, J, Hjelstuen, M H, Mjaaland, I, Dybvik, K I. Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio–visual guidance, without compromising target coverage. Acta Oncol 2011; 50: 42–50.CrossRefGoogle ScholarPubMed
11.Sixel, K E, Aznar, M C, Ung, Y C. Deep inspiration breath hold to reduce irradiated volume in breast cancer patients. Int J Radiat Oncol Biol Phys 2001; 49: 199–204.CrossRefGoogle ScholarPubMed
12.Cooper, S, Runkel, J, Wells, D, Salter, L, Olivotto, I. Respiratory gating: using Deep Inspiration Breath Hold radiation therapy to treat left breast cancer. J Med Imaging Radiat Sci 2008; 39: 192–197.CrossRefGoogle ScholarPubMed
13.Remouchamps, V, Letts, N, Vicini, Fet al. Initial clinical experience with moderate Deep-Inspiration Breath Hold using an active breathing control device in the treatment of patients with left-sided breast cancer using external beam radiation therapy. Int J Radiat Oncol Biol Phys 2003; 56 (3): 704–715.CrossRefGoogle ScholarPubMed
14.Swanson, T, Grills, I, Ye, Het al. 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. Am J Clin Oncol 2013; 36 (1): 24–30.CrossRefGoogle ScholarPubMed
15.Royal Surrey County Hospital. Deep Inspiration Breath Hold technique for Radiotherapy patient pamphlet. https://www.royalsurrey.nhs.uk/patients/information-leaflets/departments/radiotherapy. Accessed on 20 December 2013.Google Scholar
16.Nijman, J, Sixma, H, Van Triest, B, Keus, R, Hendricks, M. The quality of radiation care: the results of focus group interviews and concept mapping to explore the patient’s perspective. Radiother Oncol 2012; 102: 154–160.CrossRefGoogle ScholarPubMed