Breast conservation in breast cancer patients with cardiac pacing devices

Abstract

Patients that have implantable pacemakers and defibrillators who develop localized breast cancer have historically been considered better candidates for mastectomy than breast conservation therapy (BCT) due to the risk of device malfunction.  Many of these patients are desirous of BCT but have been felt to be unsuitable due to the disruptive potential to the pacing device resulting from the primary radiation beam and electromagnetic fields that occur during delivery of megavoltage irradiation. The use of pacing devices is growing rapidly and more patients with early-stage breast cancers have implanted devices.  Newer treatment techniques involving the use of accelerated partial breast radiotherapy (APBI) [1, 2] accompanied by recently published guidelines detailing suitability criteria for APBI [3] have changed the breast cancer paradigm. We present the Allegheny General Hospital experience in patients with early-stage breast cancer and implanted cardiac pacing devices who desired breast preservation.