Sunday, February 25, 2024

Radiation For Breast Cancer And Lung Damage

What Treatments May I Be Offered

Innovative way to target radiation

Treatment for secondary breast cancer in the lung aims to relieve symptoms and slow down the growth of the cancer.

Treatments can be given on their own or in combination.

When making decisions about how best to treat you, your treatment team will consider factors such as:

  • How extensive the cancer is within the lung
  • Whether the cancer has spread to other organs
  • Any symptoms you have
  • What treatment youve had in the past
  • The features of the cancer
  • Whether youve been through the menopause
  • Your general health

Your specialist should discuss any recommendations for treatment with you and take into account your wishes. They will talk with you about your options, explain what the aim of your treatment will be and help you weigh up the potential benefits against the possible side effects you may have.

You may also be referred to the respiratory team, which specialises in treating people with breathing difficulties. They can help plan your treatment or manage your symptoms. Your care will continue under your usual breast oncologist, but with involvement or advice from the other team.

Hormone therapy is used to treat breast cancers that are oestrogen receptor positive.

If you had a biopsy or surgery for primary breast cancer, the tissue removed will have been tested to see if it is ER+. However, in some people the oestrogen receptors change during the development of secondary breast cancer. Because of this, your doctor may discuss having a biopsy to retest for hormone receptors.

Technique And Treatment Position

For each combination of region irradiated, the average MLDipsi varied according to both technique and treatment position . The commonest treatment position was supine . The commonest techniques were tangents and intensity modulated radiotherapy . Average MLDipsi was similar for static field and rotational IMRT so these two types of IMRT were considered together.

Mean ipsilateral lung doses from left or right breast cancer radiotherapy with or without breathing adaptation according to regions irradiated and regimens used. Only studies providing doses with and without breathing adaptation in the same woman were included. Studies of women with unfavourable anatomy were excluded. *Average of mean ipsilateral lung doses for reported regimens. Range of mean ipsilateral lung doses for reported regimens. Static field IMRT and rotational IMRT are included jointly as IMRT. §Other includes one unspecified 3D conformal regimen. p values are calculated using a paired t-test. Abbreviations: CI: confidence interval IMRT: intensity modulated radiotherapy IMC: internal mammary chain SCF: supraclavicular fossa.

Effect Of Recombinant Cxcl12 And Mif On Breast Cancer Cell Growth And Migration

To verify if CXCL12 and MIF may contribute to the effects observed with the secretome of irradiated cells, the recombinant forms were supplemented to the secretome of unirradiated cells and used to assess the functional impact on cancer cells. CMLE supplemented with recombinant CXCL12 or MIF induced an increase in cell growth as demonstrated for MDA-MB-231GFP_luc cells 4A) and induced an increase in cell migration after treatment with CXCL12 4B) . Experiments with MIF did not show significant difference in cancer cell migration .

Effect of recombinant CXCL12 and MIF on breast cancer cell growth and migration

A. Box plots illustrating the relative cell growth of MDA-MB-231GFP_luc cells. Treatment of breast cancer cells with CXCL12 or MIF increases relative cell growth compared to control. Quantification by bioluminescent imaging after 4 days incubation. Data is represented as relative fold change compared with the corresponding control value . n = 6 ***, P< 0.001 . B. Box plots illustrating difference in total migrated cell number of MDA-MB-231GFP_luc cells treated with CXCL12 . Nuclei of migrated cells were stained blue with DAPI . n = 6 *, P = 0.038 .

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Is Ards Secondary To Radiation Therapy

The case authors state that they believe theirs is the first reported case of ARDS secondary to radiation therapy for breast cancer. There are also several other aspects that make this patients case notable, they note: The absence of any predisposing respiratory comorbidities that might explain the occurrence of ARDS.

Prognostic Risk Factors For Breast Cancer Patients With Subsequent Lung Cancer


A few studies have explored the prognostic factors of patients with breast cancer and second primary lung cancer with inconsistent findings. Wang et al conducted a relevant exploration by analyzing 6269 cases from the SEER databases and demonstrated that the ER , PR , histological type of breast cancer , age at the diagnosis of lung cancer , interval between the diagnosis of breast cancer and lung cancer , histological type of lung cancer , differentiation degree and tumor stage of lung cancer were significantly associated with prognosis of breast cancer patients with subsequent non-small-cell lung cancer . However, for patients with subsequent small cell lung cancer , only the tumor stage and age at the diagnosis of SCLC were prognostic factors.9

Chen et al demonstrated that chemotherapy , lymphovascular space invasion of pulmonary carcinoma and ground-glass opacity ratio< 50% were independent prognostic risk factors for this group of patients after reviewing 54 cases. Meanwhile, they also found that chemotherapy for lung cancer , worse differentiation of lung cancer , pulmonary tumor 2 cm , LVSI of pulmonary carcinoma and GGO ratio< 50% were risk factors for recurrence.48

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Chances Of Lung Damage From Breast Cancer Radiation

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Other Measures Of Lung Dose

The average V20ipsi was 15.9% and the average V5ipsi was 40.9% . For treatment in the supine position not including the IMC, there were no material differences in V20ipsi between IMRT and tangents . When the IMC was included, IMRT led to a substantially lower V20ipsi than wide tangents . Prone positioning was effective at reducing V20ipsi, and for each region category for which it was reported average V20ipsi for protons was lower than for other techniques. V5ipsi was higher for IMRT than for tangential regimens regardless of the regions irradiated . Other volumetric dose measures such as V30ipsi and V40ipsi were each reported in fewer than 50 studies.

The average MLDcont was 2.2Gy . MLDcont was higher for IMRT than for tangential regimens, regardless of the regions irradiated. For partial breast radiotherapy, the average MLDcont was 0.2Gy. For the other region categories, average MLDcont varied from 1.9 to 2.6Gy, and did not increase according to the extent of the ipsilateral regions irradiated. The lowest contralateral lung doses within each region category were from proton therapy.

The average MLDwhole was 6.0Gy . Variation according to regions irradiated, technique, and patient position was similar to MLDipsi .

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Can Radiation Treatment For Breast Cancer Cause Heart Problems

I read that if you hold your breath during radiation treatment on the left breast, there is a reduction in the amount of radiation affecting the heart. Is this true?”

Clinical trials have demonstrated a small, yet significant risk of cardiac toxicity associated with radiation therapy for breast cancer. While radiotherapy plays a crucial role in treating breast cancer, it can cause incidental damage to the heart and lungs, that may in turn increase the risk of heart disease and lung cancer.

Potential damage to the heart is influenced by the area of the chest where the tumour is located i.e. radiation targeted to the left breast increases the risk of damage to the heart. There has been some evidence that damage to the heart can be reduced by applying a particular radiation therapy technique and the breath-holding technique. The breath-holding technique is where the lungs are expanded and the heart is pushed away, out of the path of the radiation.

Cancer Council recommends you discuss questions and concerns about radiation treatment and its possible impacts on the heart with your radiation oncologist. You may want to ask the radiation oncologist about the dose of radiation you will be receiving and how the heart will be protected from the effects of radiation treatment.

How Long Do Side Effects Last After Radiation Treatment

WVU Cancer Institute: Intra-operative Radiation Therapy (IORT) for Breast Cancer

Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.

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Accelerated Partial Breast Irradiation

After whole breast radiation or even after surgery alone, most breast cancers tend to come back very close to the area where the tumor was removed . For this reason, some doctors are using accelerated partial breast irradiation in selected women to give larger doses over a shorter time to only one part of the breast compared to the entire breast . Since more research is needed to know if these newer methods will have the same long-term results as standard radiation, not all doctors use them. There are several different types of accelerated partial breast irradiation:

  • Intraoperative radiation therapy : In this approach, a single large dose of radiation is given to the area where the tumor was removed in the operating room right after BCS . IORT requires special equipment and is not widely available.
  • 3D-conformal radiotherapy : In this technique, the radiation is given with special machines so that it is better aimed at the tumor bed. This spares more of the surrounding normal breast tissue. Treatments are given twice a day for 5 days or daily for 2 weeks.
  • Intensity-modulated radiotherapy : IMRT is like 3D-CRT, but it also changes the strength of some of the beams in certain areas. This gets stronger doses to certain parts of the tumor bed and helps lessen damage to nearby normal body tissues.
  • Brachytherapy: See brachytherapy below.

Conditioned Medium Of Irradiated And Unirradiated Bronchial Epithelial Cells

Normal lung epithelial cells were cultured in a 25 cm2 culture flask. Cells were irradiated using a Small Animal Radiation Research Platform, SARRP system at a constant rate of 3.45 Gy/min, for 174 seconds, thus receiving a single-fraction of 10.0 Gy . Cells were positioned at a source-to-surface distance of 34 cm. Control sham samples received similar handlings except for the irradiation. Conditioned medium containing soluble factors derived from irradiated epithelial cells and medium of the sham epithelial cells was prepared as described in Supplementary Materials and Methods.

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Is Heart Disease A Complication Of Breast Cancer

Heart disease the No. 1 killer of women can sometimes be a complication of breast cancer treatment. Older women who survive breast cancer are more likely to die of heart disease than a cancer recurrence. Dr. Laxmi Mehta, who led the writing of a wide-ranging 2018 report on the two diseases, said the overlap exists on a spectrum.

Fat Necrosis Versus Local Recurrence


The use of MR imaging has some advantages in the differential diagnosis of fat necrosis and a recurred lesion. MR imaging with fat suppression can suggest the possibility of fat necrosis. On contrast-enhanced MR imaging, no enhancement, early enhancement and spiculated enhancement for a cystic lesion containing fat-fluid level can suggest the possibility of fat necrosis. The use of three-dimensional fat-suppressed dynamic MR imaging also appears to be efficacious for the specific detection of malignancies .

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Does Radiation Cause Heart Disease

Radiation-associated heart disease has a latency of at least five years, therefore requiring long-term follow-up of breast cancer survivors. Previous studies in older populations have shown left-sided radiation therapy is associated with increased risk of developing heart disease, although the level of risk varied between studies. According to the researchers, the risk of heart disease after receiving radiation therapy had not been previously evaluated for younger women.

Scar Tissue In Lung After Radiation Therapy For Breast Cancer

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Primary And Secondary Damage To Macromolecules

Exposure to radiation causes both direct and indirect macromolecular damage and also triggers the generation of various reactive oxygen species , including superoxide , hydrogen peroxide and hydroxyl radical . The combination of irradiation itself and the generation of ROS affect all types of macromolecules, including DNA, proteins, proteoglycans and lipids. However, double-strand breaks in DNA have most severe consequences for the cells . Primary and secondary damage triggers cascades and networks of biochemical reactions and the balance between them determines if normal lung tissue will be restored or if the fibrotic response will be initiated .

Impact Of Irradiated Lung Epithelial Cells On Breast Cancer Cell Growth And Adhesion

Radiation Therapy for Breast Cancer

Irradiated or sham-irradiated Beas-2B cells were grown in co-culture with 4T1_luc or MDA-MB-231GFP_luc triple-negative breast cancer cells and cancer cell growth was monitored by measuring luciferase activities after 4 days of co-culture. Co-culture with irradiated Beas-2B cells significantly enhanced the relative cancer cell growth 1.7-and 2.8-fold respectively compared to co-culture with unirradiated Beas-2B cells .

Impact of irradiated lung epithelial cells on breast cancer cell adhesion and growth

To study the effect on cancer cell adhesion, we seeded breast cancer cells on a monolayer of Beas-2B epithelial cells 24 hours after irradiation or sham-irradiation. Co-culture with irradiated Beas-2B cell monolayer significantly increased adhesion of both cancer cells 1.7-and 1.3-fold respectively compared to co-culture with unirradiated Beas-2B cell monolayer .

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Lung Cancer After Radiation: What To Know

When you’re in the middle of cancer treatment, your main goal is to control the disease. But you should also be aware of how each type of therapy might affect you now and in the future.

Radiation therapy uses high-energy X-rays to kill cancer. Getting it after surgery or on its own could slow your cancer’s growth or stop it from coming back. But radiation to the chest might also raise your odds of lung cancer down the road, especially if you’ve smoked for many years. The good news is that the chance of this happening is low overall. Hereâs what we know.

What Are The Types Of Radiation Therapy For Breast Cancer

There are different ways to receive radiation therapy. Your healthcare provider will choose the best method based on the cancer location, type and other factors.

Types of radiation therapy for breast cancer include:

  • External beam whole-breast irradiation: During external beam whole-breast radiation therapy, a machine called a linear accelerator sends beams of high-energy radiation to the involved breast. Most people get whole-breast radiation five days a week for one to six weeks. The time frame depends on factors including lymph node involvement. In some cases, intensity-modulated radiation therapy may be used.
  • External beam partial-breast: This treatment directs radiation to the tumor site only, not the entire breast over 1 to 3 weeks with 3-dimensional conformal radiation or IMRT.
  • Brachytherapy: Some people get internal radiation therapy or brachytherapy. Your provider places an applicator or catheter. A radioactive seed is moved into the tumor site. The seeds give off radiation for several minutes before your provider removes them. You receive two treatments every day for five days.
  • Intraoperative:Intraoperative radiation therapy takes place in the operating room before your provider closes the surgical site. Your provider delivers a high dose of radiation to the tumor area of the exposed breast tissue.

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The Risk Of Subsequent Lung Cancer In Breast Cancer Patients

During the past 20 years, an increasing number of studies have explored the difference in the risk of lung cancer between breast cancer patients and the general population. After systematically searching for relevant literature, we selected some high-quality studies and have presented them in Table 2.

Table 2 Relevant Literatures About the Risk of Subsequent Primary Lung Cancer After Breast Cancer

Utada et al included and analyzed the data of 174,477 cancer patients from the Nagasaki Prefecture Cancer Registry of Japan. Compared to the incidence of lung cancer as the first primary tumor, the risk for subsequent lung cancer in female breast cancer patients increased by approximately 40% .11 Another similar study conducted by Evans et al was based on the Thames Cancer Registry, which collected tumor-related data of residents in southeastern England involving a population of 14 million. They enrolled 112,878 cases and found that the risk of subsequent lung cancer in female breast cancer patients increased by approximately 60% compared with the general population .12 Schaapveld et al drew a similar conclusion by analyzing 58,068 cases, and female breast cancer patients were found to have a much higher risk of second primary lung cancer .13

Based on the above studies, it is relatively credible that breast cancer patients are more likely to develop lung cancer than the general population.

What Are The Complications

Efeitos colaterais da radiação para o câncer de mama: o que saber ...

Radiation pneumonitis can have some lasting effects, especially in more severe cases that arent treated. Over time, it can develop into radiation fibrosis if your symptoms dont improve. This refers to permanent scarring of your lung tissue. It usually starts to happen 6 to 12 months after radiation treatment, but it can take as long as 2 years to fully develop.

The symptoms of radiation fibrosis are similar to those of pneumonitis, but theyre usually more severe. If you have radiation pneumonitis that feels like its getting worse, your doctor may check for signs of fibrosis.

Most people recover from radiation pneumonitis within one or two weeks. If you need to take corticosteroids, you might see a major reduction in your symptoms within a day or two.

As you heal, there are also things you can do to help manage your symptoms, including:

  • drinking plenty of fluids to keep your throat moist
  • using a humidifier to add moisture to the air
  • sleeping on extra pillows to raise your upper body and make breathing easier
  • staying inside on very cold or hot and humid days, which can irritate your lungs
  • resting as soon as you feel short of breath

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