TY - JOUR
T1 - Risk of coronary stenosis after adjuvant radiotherapy for breast cancer
AU - Wennstig, A. K.
AU - Garmo, H.
AU - Wadsten, L.
AU - Lagerqvist, B.
AU - Fredriksson, I.
AU - Holmberg, L.
AU - Blomqvist, C.
AU - Nilsson, G.
AU - Sund, M.
N1 - Funding Information:
The authors wish to thank Dr Robert Zürner at the Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Sweden. This study was supported through grants from the Swedish Breast Cancer Society, the Percy Falk Foundation, VISARE Norr (grant number 931408), and the Department of Research and Development Västernorrland County Council (grant no. LVNFOU929171). The funding body had no part in the design of the study, collection, analysis, and interpretation of data, or in writing the manuscript.
Funding Information:
This study was supported through grants from the Swedish Breast Cancer Society, the Percy Falk Foundation, VISARE Norr (grant number 931408), and the Department of Research and Development Västernorrland County Council (grant no. LVNFOU929171). The funding body had no part in the design of the study, collection, analysis, and interpretation of data, or in writing the manuscript.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/7
Y1 - 2022/7
N2 - Purpose: Adjuvant radiotherapy (RT) for breast cancer is associated with an increased risk of ischemic heart disease. We examined the risk of coronary artery stenosis in a large cohort of women with breast cancer receiving adjuvant RT. Methods: A cohort of women diagnosed with breast cancer between 1992 and 2012 in three Swedish health care regions (n = 57,066) were linked to the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) to identify women receiving RT who subsequently underwent a percutaneous coronary intervention (PCI) due to coronary stenosis. Cox regression analyses were performed to examine risk of a coronary intervention and competing risk analyses were performed to calculate cumulative incidence. Results: A total of 649 women with left-sided breast cancer and 494 women with right-sided breast cancer underwent a PCI. Women who received left-sided RT had a significantly higher risk of a PCI in the left anterior descending artery (LAD) compared to women who received right-sided RT, hazard ratio (HR) 1.44 (95% confidence interval [CI] 1.21–1.77, p < 0.001). For the proximal, mid, and distal LAD, the HRs were 1.60 (95% CI 1.22–2.10), 1.38 (95% CI 1.07–1.78), and 2.43 (95% CI 1.33–4.41), respectively. The cumulative incidence of coronary events at 25 years from breast cancer diagnosis were 7.0% in women receiving left-sided RT and 4.4% in women receiving right-sided RT. Conclusion: Implementing and further developing techniques that lower cardiac doses is important in order to reduce the risk of long-term side effects of adjuvant RT for breast cancer.
AB - Purpose: Adjuvant radiotherapy (RT) for breast cancer is associated with an increased risk of ischemic heart disease. We examined the risk of coronary artery stenosis in a large cohort of women with breast cancer receiving adjuvant RT. Methods: A cohort of women diagnosed with breast cancer between 1992 and 2012 in three Swedish health care regions (n = 57,066) were linked to the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) to identify women receiving RT who subsequently underwent a percutaneous coronary intervention (PCI) due to coronary stenosis. Cox regression analyses were performed to examine risk of a coronary intervention and competing risk analyses were performed to calculate cumulative incidence. Results: A total of 649 women with left-sided breast cancer and 494 women with right-sided breast cancer underwent a PCI. Women who received left-sided RT had a significantly higher risk of a PCI in the left anterior descending artery (LAD) compared to women who received right-sided RT, hazard ratio (HR) 1.44 (95% confidence interval [CI] 1.21–1.77, p < 0.001). For the proximal, mid, and distal LAD, the HRs were 1.60 (95% CI 1.22–2.10), 1.38 (95% CI 1.07–1.78), and 2.43 (95% CI 1.33–4.41), respectively. The cumulative incidence of coronary events at 25 years from breast cancer diagnosis were 7.0% in women receiving left-sided RT and 4.4% in women receiving right-sided RT. Conclusion: Implementing and further developing techniques that lower cardiac doses is important in order to reduce the risk of long-term side effects of adjuvant RT for breast cancer.
KW - Ischemic heart disease
KW - LAD (left anterior descending artery)
KW - PCI (percutaneous coronary intervention)
KW - Side effects
KW - Survivorship
UR - http://www.scopus.com/inward/record.url?scp=85127682868&partnerID=8YFLogxK
U2 - 10.1007/s00066-022-01927-0
DO - 10.1007/s00066-022-01927-0
M3 - Article
AN - SCOPUS:85127682868
SN - 0179-7158
VL - 198
SP - 630
EP - 638
JO - Strahlentherapie Und Onkologie
JF - Strahlentherapie Und Onkologie
IS - 7
ER -
