Cleveland Clinic Doctors Develop Breast Shield to Protect Women from Risks

Associated with Breast Treatment 'Scatter Damage'

CLEVELAND, Aug. 29 /PRNewswire/ -- Specialists at The Cleveland Clinic who provide radiotherapy for women with breast cancer are pioneering use of ashield designed to protect healthy breast tissue from "scatter damage" that might be caused by radiation that spills over from the treatment area to the healthy breast on the opposite side.

Development of the breast shield and the risk for contralateral breast cancer risk are outlined in a series of recent papers published by the Cleveland Clinic Research Group. The latest developments will be reviewed in a major paper appearing in the September issue of Radiotherapy & Oncology, the Journal of the European Society For Therapeutic Radiology And Oncology. Roger M. Macklis, M.D., chairman of the Department of Radiation Oncology at The Cleveland Clinic, said researchers were prompted to develop the breast shield by the growing use of radiotherapy for women who receive breast-conserving treatment for breast cancer.

Dr. Macklis acknowledged that the risk for contralateral breast cancer has yet to be fully recognized in scientific literature. He said, however, that taking this precaution makes sense, given what is known about radiation exposure and breast cancer.

"As far back as studies of the victims of the atomic bomb in Hiroshima and before, doctors have known that breast cancer development is a risk of radiation exposure," Dr. Macklis said. "At the same time, radiation is a powerful therapy for the eradication of already existing cancer cells. In most radiation treatment centers, few, if any, precautions are taken to protect the healthy breast from scattered radiation. With the use of our new shield, however, doctors everywhere soon may be able to provide women with significant protection from this potential danger."

Dr. Macklis emphasized that radiation risks to healthy breast tissue in radiotherapy treatment appear to be insignificant for a majority of women. The review of data on contralateral breast cancer risk, however, indicates there might be a small group of patients with known epidemiological risk factors who may be at increased risk of developing second breast cancers in the opposite breast.

"This group might consist of women with either a very positive family history, known BRCA1/2 genetic mutations or patients with very early onset of breast cancer diagnosis," Dr. Macklis said. "There should be additional large scale clinical studies to analyze the risk of breast radiotherapy in this potentially high-risk group.

"These studies, however, will take many years to evaluate. In the meantime, it makes sense to reduce radiation exposure for all groups to the lowest reasonable levels," Dr. Macklis said. "We thought it would be unreasonable to limit the breast-sparing treatment options to women in the higher risk groups. We, therefore, decided to develop a device and a technology to minimize scatter-related risk for all patients."

Dr. Macklis said a team of Cleveland Clinic radiation oncologists and physicists developed the first working model of the mobile breast shield in 1999. A clinical trial demonstrated the shield cut the radiation dose to healthy breasts by 60 to 70 percent. The breast shield technology is now available to virtually any woman receiving radiotherapy for breast cancer at The Cleveland Clinic.

"We believe that if we have a way to block this scatter radiation, we should block it. And we believe that if this increases patient satisfaction and provides a greater sense of security in choosing breast-conserving treatment options, this protective device should be available to any woman who is receiving radiotherapy for breast cancer," Dr. Macklis said. "We want to be proactive in eliminating this potential source of concern."

The Cleveland Clinic Foundation, founded in 1921, integrates clinical and hospital care with research and education in a private, not-for-profit group practice. Approximately 1,100 full-time salaried physicians at The Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialties and subspecialties. In 2000, there were more than 2 million outpatient visits to The Cleveland Clinic Foundation. Patients came for treatment from every state and from more than 80 countries. There were more than 51,000 hospital admissions to The Cleveland Clinic Foundation in 2000. The Cleveland Clinic website address is www.clevelandclinic.org .