Challenges of maintaining breath-hold conformity for breast patients while using the DIBH technique

Deep inspiration breath-hold (DIBH) is used for whole breast radiotherapy, as a means of providing better dose homogeneity. This can be achieved by lower doses to the organs at risk, less patient movement and better set up. Most patients offered DIBH treatment are left-sided breast cancer, or ductal carcinoma in situ (DCIS) patients, due to the proximity of the heart to the chest wall so it is nearer the radiation field. However, if lung sparing is essential for the patient, DIBH offers a solution for right-sided breast cancer patients also.

St Luke’s Cancer Centre at Royal Surrey County Hospital introduced a DIBH service in June 2012 for left-sided breast cancer patients. This service was initially introduced at a low level, with the increase in capacity over the course of 18 months achieving a service roll out to all left-sided breast patients, and selected right-sided breast patients.

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