Dr. Jean Wright, fellowship trained radiation oncologist, discusses treatment options for breast cancer, including the use of proton therapy for left breast cancer, and how the multidisciplinary team at Johns Hopkins manages all breast cancer cases. My name is Jean right, and I am an associate professor of radiation oncology and molecular radiation sciences at Johns Hopkins University. I practice at our location in Washington, D. C. Sibley Memorial Hospital and the Sibley Proton Center. There's a lot of interest in the use of proton radiation therapy in breast cancer, particularly for patients with left sided disease. This is because the heart is situated slightly more to the left than the right. Traditional photon based radiation therapy can, in some cases, confer a relatively higher radiation exposure to the heart compared to what can be achieved with protons again. That depends on the patient's anatomy, whether or not there are meaningful differences in the heart exposure between protons and photons. But in some cases protons can significantly reduce the radiation exposure to the heart. Compared to the photon treatment every breast cancer patient that we see, we evaluate for what is going to be the optimal approach to their care, including the optimal technology. We have a spectrum of technologies that we offer for our patients, and protons is one of them. So for every patient, we're going to evaluate whether protons is a consideration and has any potential benefit for that patient. The patients that we will most commonly recommend protons for are going to be patients who have left sided breast cancer and who, based on their clinical scenario, we are recommending radiation to the internal mammary lymph nodes, which are a group of lymph nodes on the inner side of the breast tissue that actually lie underneath the ribs and are sandwiched in many cases between, um, the chest wall or the ribs and the heart. Ah, physician who makes a referral to me or to any of the breast cancer specialists in our radiation oncology department should know that we really consider each patient azi unique individual. And we will consider the full spectrum of possible treatment choices for that patient, which could include considering what tissues need to be radiated, what dose of radiation we need to use and how maney radiation sessions are gonna be recommended. We have, depending on the situation options that ranged from Onley one radiation treatment up to 5 to 6 weeks of radiation treatment, depending on the patient's clinical uh, situation. Our group really functions in a multi disciplinary fashion. We run all of our cases through our internal radiation oncology group. And we also discuss the majority of our cases in multidisciplinary settings, including tumor boards and Baltimore and in the national capital Region that are joined by members of the team, including surgery, medical oncology, radiology, pathology, genetics. Um, you know all the different members of the breast cancer team that are important to developing a treatment plan and for caring for our patients. Eso When you make a referral to the radiation oncology department, you're really, um, bringing the patient into a strong sort of multi disciplinary program that I think can really tailor and optimize our recommendations to the patient, okay?