S259
Clinical - Breast
ESTRO 2026
Kim A, Kalet AM, Cao N, et al. Effects of Preparatory Coaching and Home Practice for Deep Inspiration Breath Hold on Cardiac Dose for Left Breast Radiation Therapy. Clin Oncol (R Coll Radiol). 2018;30(9):571-577. doi:10.1016/j.clon.2018.04.009Mayr NA, Borm KJ, Kalet AM, et al. Reducing Cardiac Radiation Dose From Breast Cancer Radiation Therapy With Breath Hold Training and Cognitive Behavioral Therapy. Top Magn Reson Imaging. 2020;29(3):135-148. doi:10.1097/RMR.0000000000000241Aznar MC, Carrasco de Fez P, Corradini S, et al. ESTRO-ACROP guideline: Recommendations on implementation of breath-hold techniques in radiotherapy. Radiother Oncol. 2023;185:109734. doi:10.1016/j.radonc.2023.109734 Keywords: Deep Inspiration Breath Hold, Issues, Tolerance External beam re-irradiation in loco-regional recurrent breast cancer – experience from two university hospitals in Munich Manuela Kastner 1 , Marita Wolf 2 , Jana Nano 1 , Sophie T. Behzadi 1 , Rebecca Moser 1 , Sophia Kiesl 1 , Luisa Allwohn 1 , Sophie Maier 1 , Lena M. Buchecker 1 , Montserrat Pazos 2 , Annemarie Zinn 2 , Claus Belka 2 , Stefanie Corradini 3 , Stephanie E. Combs 1,4 , Kai J. Borm 1 1 Department of Radiation Oncology, TUM School of Medicine and Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany. 2 Department of Radiation Oncology, University Hospital LMU Munich, Munich, Germany. 3 Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany. 4 Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764 Oberschleißheim, Germany Purpose/Objective: The optimal approach for loco-regional recurrence of breast cancer (LRRBC) remains controversial. Re- radiotherapy in combination with a second breast- conserving surgery may represent an alternative to mastectomy (current standard option). However, the available evidence regarding oncologic outcomes and toxicity remains limited; particularly for external beam re-irradiation (EBRe-RT), although this technique is most frequently used. Therefore, we assess treatment- Digital Poster 1849 related toxicity, long-term oncologic outcomes, patient-reported outcomes, and quality of life (QoL) after EBRe-RT for LRRBC; supported by Else Kröner- Fresenius-Stiftung (EKFS), Germany. Material/Methods: A retrospective analysis of 181 LRRBC patients who
therapy (RT) treatment (1,2). Understanding barriers to tolerance can guide interventions and optimise resource use (3), particularly in rural settings.We aimed to: i) identify categories of issues patients face with DIBH; ii) develop and implement a screening program to assess patients for DIBH suitability; and iii) evaluate the effectiveness of the program to identify DIBH appropriate patients and maximise their capacity to participate. Material/Methods: We retrospectively reviewed the electronic medical records of all breast cancer patients offered DIBH between 2020 and 2024 at the North Coast Cancer Institute, Lismore, New South Wales, Australia. Patient characteristics and reasons for DIBH intolerance were extracted from clinical records to create a screening tool. From 2023, a structured screening program was introduced to assess DIBH suitability and classify patients as: (1) able to without intervention; (2) able to with intervention; or (3) unable to with intervention. Descriptive statistics were used to summarise findings. Results: DIBH was offered to 214 patients, median 64 years (range 30–89), with 75 (35%) unable to tolerate DIBH. The DIBH intolerance issues were categorised into respiratory-related (n=42; 20%), physical and pain- related (n=16; 8%), psychological factors (n=12; 6%), and chemotherapy side-effects (n=5; 2%). Of the remaining 139 patients, 32 (23%) reported pain-related factors, six (4%) anxiety, five (3.5%) respiratory issues, and one each reported chemotherapy side-effects and limited English skills that initially limited but did not prevent participation in DIBH. These factors were embedded into a structured screening program to assess patients’ DIBH tolerance.The screening program effectiveness was evaluated by matching screening outcomes with DIBH suitability confirmed at CT simulation. Of 52 patients screened, 50 (96%) matched DIBH assessment within their simulation session whereas two did not as they were screened seated. Of the screened patients, 7 (13%) were referred for intervention which enabled their participation in DIBH. Conclusion: Several reasons for DIBH intolerance were identified, with respiratory-related issues most frequent. Pain- related issues were the most common limitation among patients who completed DIBH. Implementing a structured screening program proved effective in identifying DIBH tolerance, reducing resource burden, supporting early intervention, and improving patient- centred decision making. Routine adoption of screening is recommended to optimise DIBH delivery, particularly in resource-limited settings. Future research should evaluate interventions to improve patients’ ability to participate in DIBH. References:
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