The effectiveness of prone breast irradiation for the treatment of breast cancer

Aim In the United Kingdom, breast cancer affected more than 45,500 women in 2005, meaning that approximately 125 women were being diagnosed with this disease every day, making breast cancer the most common cancer in the UK. However, more women are surviving breast cancer than before. The aim of this literature review was to determine if prone breast irradiation is the most effective treatment technique for women with large, pendulous breasts undergoing breast conservation therapy. The hypothesis suggests that breast irradiation in the prone position using three dimensional planning is the most effective treatment technique. Methods Literature was searched to collect information about prone breast irradiation in comparison to supine irradiation. Journals and books were searched and analysed using triangulation methods. The literature was then critically appraised to determine the optimum treatment. Findings The findings demonstrated that prone breast irradiation is more beneficial than supine irradiation, in terms of improved patient immobilisation being achieved and limited interfractional variability. The radiation doses received by critical organs such as the heart, lung and contralateral breast are significantly reduced. Finally, the prone position has also shown a better treatment outcome in terms of cosmesis than for women undergoing breast irradiation in the supine position. However, research shows that the prone position is not suitable for all patients, i.e. obese women, the elderly, frail patients and those with nodal involvement. Conclusions From the findings of this review, the hypothesis has been accepted, but it is vital to assess tolerance of the position for the patient. It is recommended that more research be carried out on this technique. Longer patient follow ups could determine the benefits that IMRT has to offer.