Long-term risk of ischemic heart disease after adjuvant radiotherapy in breast cancer: results from a large populationbased cohort

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Long-term risk of ischemic heart disease after adjuvant radiotherapy in breast cancer : results from a large populationbased cohort

Wennstig, Anna-Karin (author): Umeå universitet,Kirurgi,Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden;Sundsvall Hosp, Dept Oncol, Sundsvall, Sweden

Wadsten, Charlotta (author): Umeå universitet,Kirurgi,Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden;Sundsvall Hosp, Dept Surg, Sundsvall, Sweden

Garmo, Hans (author): Uppsala Univ, Uppsala Univ Hosp, Reg Canc Ctr, Uppsala, Sweden;Kings Coll London, TOUR, Sch Canc & Pharmaceut Sci, London, England

Fredriksson, Irma (author): Karolinska Institutet

Blomqvist, Carl (author): Orebro Univ, Univ Hosp, Dept Oncol, Orebro, Sweden

Holmberg, Lars (author): Uppsala universitet,Endokrinkirurgi,Kings Coll London, TOUR, Sch Canc & Pharmaceut Sci, London, England

Nilsson, Greger (author): Uppsala universitet,Experimentell och klinisk onkologi,Gavle Cent Hosp, Dept Oncol, Gavle, Sweden;Visby Hosp, Dept Oncol, Visby, Sweden

Sund, Malin (author): Umeå universitet,Kirurgi,Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden

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2020-01-22
2020
English.
In: Breast Cancer Research. - London : BioMed Central. - 1465-5411 .- 1465-542X. ; 22:10

Related links:: https://doi.org/10.1...; show more...; https://umu.diva-por... (primary) (Raw object); https://breast-cance...; https://uu.diva-port... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; http://kipublication...; show less...

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BACKGROUND: Adjuvant radiotherapy (RT) for breast cancer (BC) has been associated with an increased risk of ischemic heart disease (IHD). We examined the incidence of IHD in a large population-based cohort of women with BC.METHODS: The Breast Cancer DataBase Sweden (BCBaSe) includes all women diagnosed with BC from 1992 to 2012 (n = 60,217) and age-matched women without a history of BC (n = 300,791) in three Swedish health care regions. Information on comorbidity, educational level, and incidence of IHD was obtained through linkage with population-based registries. The risk of IHD was estimated by Cox proportional hazard regression analyses and cumulative incidence by the Kaplan-Meier method.RESULTS: Women with BC had a lower risk of IHD compared to women without BC with a hazard ratio (HR) of 0.91 (95% CI 0.88-0.95). When women with left-sided BC were compared to right-sided BC, an increased HR for IHD of 1.09 (95% CI 1.01-1.17) was seen. In women receiving RT, a HR of 1.18 (95% CI 1.06-1.31) was seen in left-sided compared to right-sided BC, and the HRs increased with more extensive lymph node involvement and with the addition of systemic therapy. The cumulative IHD incidence was increased in women receiving left-sided RT compared to right-sided RT, starting from the first years after RT and sustained with longer follow-up.CONCLUSIONS: Women given RT for left-sided BC during 1992 to 2012 had an increased risk of IHD compared to women treated for right-sided BC. These women were treated in the era of three-dimensional conformal RT (3DCRT), and the results emphasize the importance of further developing and implementing RT techniques that lower the cardiac doses, without compromising the beneficial effects of RT.

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By the author/editor: Wennstig, Anna-K ...; Wadsten, Charlot ...; Garmo, Hans; Fredriksson, Irm ...; Blomqvist, Carl; Holmberg, Lars; show more...; Nilsson, Greger; Sund, Malin; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

Articles in the publication: Breast Cancer Re ...

By the university: Umeå University; Uppsala University; Karolinska Institutet

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Long-term risk of ischemic heart disease after adjuvant radiotherapy in breast cancer : results from a large populationbased cohort

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