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Dr. David
Dr. David, Doctor
Category: Cardiology
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Experience:  Experienced physician with cardiology experience
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Can a patient with a pace maker is able to support a

Customer Question

Can a patient with a pace maker is able to support a radio-therapy of the breast on the same side.
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. David replied 1 year ago.

This is Dr. David

it depends on the type of breast cancer

some women are elegible for partial breast radiation therapy to part of their breast if their breast cancer is small and ER positive and they had a good lumpectomy surgery without lymph node involvement.

if the pacemaker can be kept outside of the radiation field, they could be able to have breast radiation therapy.

Expert:  Nadim Al-Mubarak replied 1 year ago.

Greetings

I am a board-certified cardiologist and happy to help you

Pace maker malfunction during radiation therapy is uncommon, and it is not contra-indication for radiation therapy. The currently available technology allows the radiation oncologist to avoid the pace maker site. Even if it ends up within the radiation field, malfunction is uncommon. It is, however, recommended that during the treatment period home-based pacemaker checks are done more frequently.

I hope this answers your question. Let me know if you need any further clarifications

Expert:  Dr. David replied 1 year ago.

This is Dr. David

I am a radiation oncology doctor.

a pacemaker inside of a radiation field would get full dose of radiation and this could cause damage to the pacemaker

I have had my dosimetrist call up St. Judes and Medtronic before on their guidelines on pacemakers and radiation exposure.

they usually give rough estimates of limits of no more than 2-3Gy worth of radiation exposure.

this means that the pacemaker has to be outside of the radiation field.

conventional whole breast radiation therapy is usually to 50Gy with a boost to 60Gy to the tumor bed lumpectomy site.

in canada, Dr. Whelans' protocol is 16 fractions to 42.65Gy to the whole breast.

partial breast fractionation is usually 38.65Gy in 10 fractions twice a day for 10 fractions in 5 days to the seroma plus a 2cm margin.

so it does matter where the surgery was done and what type of breast cancer you had and what type of radiation is allowable.

let me know if you have other questions.

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