Which Patients with Left Breast Cancer Should be Candidates for Heart-Sparing Radiotherapy?.
10.4048/jbc.2018.21.2.206
- Author:
Won Kyung CHO
1
;
Won PARK
;
Doo Ho CHOI
;
Hyejung CHA
;
Seok Jin NAM
;
Seok Won KIM
;
Jeong Eon LEE
;
Jonghan YU
;
Young Hyuck IM
;
Jin Seok AHN
;
Yeon Hee PARK
;
Ji Yeon KIM
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonro.park@samsung.com
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
Cardiotoxicity;
Radiotherapy
- MeSH:
Body Mass Index;
Breast Neoplasms*;
Breast*;
Carcinoma, Intraductal, Noninfiltrating;
Cardiotoxicity;
Cardiovascular Diseases;
Female;
Heart;
Humans;
Hyperlipidemias;
Hypertension;
Incidence;
Mastectomy, Segmental;
Radiation Exposure;
Radiotherapy*;
Risk Factors;
Smoke;
Smoking;
Trastuzumab
- From:Journal of Breast Cancer
2018;21(2):206-212
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to identify risk factors that have significant interaction with radiation exposure to the heart, and thus to determine candidates for heart-sparing radiotherapy (RT) among women with left breast cancer. METHODS: We identified 4,333 patients who received adjuvant RT following breast-conserving surgery for ductal carcinoma in situ or invasive breast cancer from 1996 to 2010. Incidence rates of cardiovascular disease were compared between left-sided and right-sided RT, and stratified by age and risk factors such as body mass index (BMI), smoking, hyperlipidemia, hypertension, diabetes, administration of anthracycline, and trastuzumab. RESULTS: In all patients, the cumulative incidence of cardiovascular disease was greater in patients treated with left-sided RT than in those treated with right-sided RT, but the difference was not significant (p=0.428). Smoking (hazard ratio [HR], 5.991; 95% confidence interval [CI], 2.109–17.022; p=0.002) and hyperlipidemia (HR, 5.567; 95% CI, 3.235–9.580; p<0.001) were the most powerful risk factors for cardiovascular disease. There was no significant factor that further increased the risk of cardiovascular disease after left breast RT compared to right breast RT. CONCLUSION: Although hyperlipidemia and smoking are risk factors for cardiovascular disease, they have not been proven to increase the risk of RT-related cardiovascular disease in Korean women.
