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

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

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2020-01-22
  • London :BioMed Central,2020
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-167724
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-167724URI
  • https://doi.org/10.1186/s13058-020-1249-2DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-407283URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:143023528URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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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  • Wadsten, CharlottaUmeå universitet,Kirurgi,Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden;Sundsvall Hosp, Dept Surg, Sundsvall, Sweden(Swepub:umu)chwa0052 (author)
  • Garmo, HansUppsala Univ, Uppsala Univ Hosp, Reg Canc Ctr, Uppsala, Sweden;Kings Coll London, TOUR, Sch Canc & Pharmaceut Sci, London, England (author)
  • Fredriksson, IrmaKarolinska Institutet (author)
  • Blomqvist, CarlOrebro Univ, Univ Hosp, Dept Oncol, Orebro, Sweden (author)
  • Holmberg, LarsUppsala universitet,Endokrinkirurgi,Kings Coll London, TOUR, Sch Canc & Pharmaceut Sci, London, England(Swepub:uu)larsholmb (author)
  • Nilsson, GregerUppsala universitet,Experimentell och klinisk onkologi,Gavle Cent Hosp, Dept Oncol, Gavle, Sweden;Visby Hosp, Dept Oncol, Visby, Sweden(Swepub:uu)grnil933 (author)
  • Sund, MalinUmeå universitet,Kirurgi,Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden(Swepub:umu)masu0021 (author)
  • Umeå universitetKirurgi (creator_code:org_t)

Related titles

  • In:Breast Cancer ResearchLondon : BioMed Central22:101465-54111465-542X

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