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MINI REVIEW article

Front. Oncol.

Sec. Radiation Oncology

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1647080

This article is part of the Research TopicAI-Based Prognosis Prediction and Dose Optimization Strategy in Radiotherapy for Malignant TumorsView all 10 articles

Multidisciplinary Strategies to Reduce Radiotherapy-Induced Cardiotoxicity in Breast Cancer: Surgical and Technological Innovations

Provisionally accepted
  • 1Department of Thyroid and Breast Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, China, Zhenjiang, China
  • 2Institute of Medical Imaging and Artificial Intelligence of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, China, Zhenjiang, China

The final, formatted version of the article will be published soon.

Radiotherapy remains essential in breast cancer management, yet its long-term cardiotoxicity, driven primarily by radiation-induced myocardial fibrosis, threatens survivorship, particularly in left-sided tumors. Surgical refinements, including breast-conserving surgery with sentinel lymph node biopsy and total mastectomy, effectively reduce radiation fields and cardiac exposure. Intraoperative radiotherapy with lead shielding markedly lowers left anterior descending artery dose from 5.2 Gy to 0.07 Gy. Technological advances-such as deep-inhalation breath-hold, proton therapy exploiting the Bragg peak, and intensity-modulated radiotherapy, further optimize cardiac sparing while preserving oncologic efficacy. Integrating intraoperative image guidance, pharmacological cardioprotection, and AI-assisted planning facilitates precise dose delivery tailored to individual anatomy and risk. This review synthesizes multidisciplinary strategies to mitigate cardiac injury through surgical and technological innovation, underscoring a paradigm shift toward organ-sparing precision radiotherapy.Future directions include the application of degradable shielding materials, senescence-targeted therapies, and predictive modeling to balance therapeutic efficacy with long-term cardiovascular safety in breast cancer care.

Keywords: breast cancer, Radiotherapy, cardiotoxicity, Cardiac protection, Radiotherapy-induced cardiotoxicity

Received: 14 Jun 2025; Accepted: 28 Jul 2025.

Copyright: © 2025 LU, Sun and Yi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Zhenhua Sun, Department of Thyroid and Breast Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, China, Zhenjiang, China

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