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Chen WY, Gan ZY, Cai YW, Hua ZQ, Yi L. Advances in deep inspiration breath-hold technique for radiotherapy of right-sided breast cancer. World J Transl Med 2026; 12(4): 126251 [DOI: 10.5528/wjtm.126251]
World J Transl Med. Nov 28, 2026; 12(4): 126251 Published online Nov 28, 2026. doi: 10.5528/wjtm.126251
Advances in deep inspiration breath-hold technique for radiotherapy of right-sided breast cancer
Wan-Yi Chen, Zi-Yang Gan, Yu-Wei Cai, Zhi-Qiang Hua, Liang Yi
Wan-Yi Chen, Liang Yi, Department of Oncology, Yueyang Hospital Affiliated to Hunan Normal University, Yueyang 414000, Hunan Province, China
Wan-Yi Chen, Yueyang Hospital Affiliated to Hunan Normal University, Hunan Normal University, Yueyang 414000, Hunan Province, China
Zi-Yang Gan, Yu-Wei Cai, Zhi-Qiang Hua, Liang Yi, Radiation Therapy Center, Yueyang Hospital Affiliated to Hunan Normal University, Yueyang 414000, Hunan Province, China
Author contributions: Chen WY and Yi L designed the research study; Chen WY, Gan ZY, Cai YW, and Hua ZQ performed the literature search and data extraction; Chen WY and Yi L analyzed and interpreted the data; Chen WY drafted the original manuscript; Yi L reviewed and edited the manuscript; and all authors have read and approved the final version.
AI contribution statement: In accordance with the artificial intelligence (AI) Tool Usage Policy of World Journal of Translational Medicine, the authors disclose the following use of AI tools during manuscript preparation. The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions. (1) DeepSeek (AI language model, DeepSeek Inc.): Used for language editing and proofreading, including English-to-Chinese and Chinese-to-English translation assistance, language polishing, grammar correction, logical verification, and wording optimization. The use of this tool was limited to linguistic refinement and did not extend to generating scientific content, research data, or analytical conclusions; and (2) Minmo (AI-assisted coding assistant): Used to assist in writing and executing R code for generating Figure 1 (deep inspiration breath-hold clinical implementation workflow diagram). The tool assisted in code development and figure output; the conceptual design, clinical workflow logic, and final figure content were determined entirely by the authors. The manuscript text, core scientific viewpoints, research content, literature analysis, and scholarly interpretation are the original work of the authors.
Supported by the China Science Exchange Foundation (Biomedical Innovation and Development Technology Public Welfare Project), No. SWYY2026002205.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Liang Yi, MD, Department of Oncology, Yueyang Hospital Affiliated to Hunan Normal University, No. 263 Baling East Road, Yueyang 414000, Hunan Province, China. yiliangjs@126.com
Received: July 29, 2026 Revised: August 23, 2026 Accepted: October 9, 2026 Published online: November 28, 2026 Processing time: 98 Days and 12 Hours
Abstract
Deep inspiration breath-hold (DIBH) has become increasingly common in the postoperative radiotherapy of left-sided breast cancer, owing to its well-established role in sparing the heart and ipsilateral lung. For right-sided tumors, however, the clinical benefit of this technique is considerably less well defined. In most studies to date, DIBH has been shown to reduce both V20 and mean lung dose in right-sided breast cancer, with larger gains observed when regional nodal irradiation is included. The liver also appears to derive a dosimetric advantage. Cardiac findings are more mixed: While some reports indicate measurable reductions in whole-heart and right coronary artery doses, the decreases are typically small and exhibit substantial interpatient variability. Meanwhile, contralateral breast doses seem largely unaffected. Regarding breath-hold monitoring, the vast majority of investigations have utilized real-time position management or the optical surface monitoring system, whereas active breathing control has seen comparatively limited application in this context. Taken together, the existing evidence supports the use of right-sided DIBH for lung and liver protection; however, its value for the heart and contralateral breast remains uncertain, and further prospective studies are warranted to clarify these issues.
Core Tip: Deep inspiration breath-hold (DIBH) is well known for shielding the heart and lung during left-sided breast radiotherapy, but whether it helps right-sided patients remains unclear. For right-sided tumors, the main organs at risk include the lung on the same side, the liver, the heart, the right coronary artery, and the breast on the opposite side. Current data show that breath-hold can cut doses to the right lung and liver, yet it does not seem to spare the heart or the contralateral breast much. In practice, DIBH is mostly delivered with real-time position management or optical surface monitoring; active breathing control is rarely used in this context. More research is needed going forward.
