Long-term cardiovascular mortality after radiotherapy for breast cancer.

COMMENT:
This is a long-term study on heart disease in women who have under gone radiation treatment for breast cancer. It shows a 1/3 increase in deaths from heart disease in any women treated with radiation, and a over 56% increase for women who received radiation on the left breast.

Anyone who has received radiation treatment for breast cancer should be extra careful with their cardiovascular risk factors. Heart disease is very easy for us to treat.

CITATION:
1. Bouillon K, Haddy N, Delaloge S, et al. Long-term cardiovascular mortality after radiotherapy for breast cancer. Journal of the American College of Cardiology. 2011;57(4):445-52. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21251585 [Accessed July 28, 2011].

ABSTRACT:
Objectives
Background Methods Results
This study sought to investigate long-term cardiovascular mortality and its relationship to the use of radiotherapy for breast cancer.
Cardiovascular diseases are among the main long-term complications of radiotherapy, but knowledge is limited regarding long-term risks because published studies have, on average, 20 years of follow-up.
A total of 4,456 women who survived at least 5 years after treatment of a breast cancer at the Institut Gustave Roussy between 1954 and 1984 were followed up for mortality until the end of 2003, for over 28 years on average.
A total of 421 deaths due to cardiovascular diseases were observed, of which 236 were due to cardiac disease. Women who had received radiotherapy had a 1.76-fold (95% confidence interval [CI]: 1.34 to 2.31) higher risk of dying of cardiac disease and a 1.33-fold (95% CI: 0.99 to 1.80) higher risk of dying of vascular disease than those who had not received radiotherapy. Among women who had received radiotherapy, those who had been treated for a left-sided breast cancer had a 1.56-fold (95% CI: 1.27 to 1.90) higher risk of dying of cardiac dis- ease than those treated for a right-sided breast cancer. This relative risk increased with time since the breast cancer diagnosis (p  0.05).
Conclusions
This study confirmed that radiotherapy, as delivered until the mid-1980s, increased the long-term risk of dying of cardiovascular diseases. The long-term risk of dying of cardiac disease is a particular concern for women treated for a left-sided breast cancer with contemporary tangential breast or chest wall radiotherapy. This risk may in- crease with a longer follow-up, even after 20 years following radiotherapy. (J Am Coll Cardiol 2011;57: 445–52) © 2011 by the American College of Cardiology Foundation