Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors
Radiotherapy of the left breast is associated with higher cardiovascular mortality linked to cardiotoxic effect of irradiation. Radiotherapy of inner quadrants can be associated with greater heart irradiation, but no study has evaluated the effect of inner-quadrant irradiation on cardiovascular mort...
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| Veröffentlicht in: | Annals of oncology 2010-03, Vol.21 (3), p.459-465 |
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| creator | Bouchardy, C. Rapiti, E. Usel, M. Majno, S. Balmer Vlastos, G. Benhamou, S. Miralbell, R. Neyroud-Caspar, I. Verkooijen, H.M. Vinh-Hung, V. |
| description | Radiotherapy of the left breast is associated with higher cardiovascular mortality linked to cardiotoxic effect of irradiation. Radiotherapy of inner quadrants can be associated with greater heart irradiation, but no study has evaluated the effect of inner-quadrant irradiation on cardiovascular mortality.
We identified 1245 women, the majority with breast-conserving surgery, irradiated for primary node-negative breast cancer from 1980 to 2004 registered at the Geneva Cancer Registry. We compared breast cancer-specific and cardiovascular mortality between inner-quadrant (n=393) versus outer-quadrant tumors (n=852) by multivariate Cox regression analysis.
After a mean follow-up of 7.7 years, 28 women died of cardiovascular disease and 91 of breast cancer. Patients with inner-quadrant tumors had a more than doubled risk of cardiovascular mortality compared with patients with outer-quadrant tumors (adjusted hazard ratio 2.5; 95% confidence interval 1.1–5.4). Risk was particularly increased in the period with higher boost irradiation. Patients with left-sided breast cancer had no excess of cardiovascular mortality compared with patients with right-sided tumors.
Radiotherapy of inner-quadrant breast cancer is associated with an important increase of cardiovascular mortality, a possible result of higher irradiation of the heart. For patients with inner-quadrant tumors, the heart should be radioprotected. |
| doi_str_mv | 10.1093/annonc/mdp341 |
| format | Article |
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We identified 1245 women, the majority with breast-conserving surgery, irradiated for primary node-negative breast cancer from 1980 to 2004 registered at the Geneva Cancer Registry. We compared breast cancer-specific and cardiovascular mortality between inner-quadrant (n=393) versus outer-quadrant tumors (n=852) by multivariate Cox regression analysis.
After a mean follow-up of 7.7 years, 28 women died of cardiovascular disease and 91 of breast cancer. Patients with inner-quadrant tumors had a more than doubled risk of cardiovascular mortality compared with patients with outer-quadrant tumors (adjusted hazard ratio 2.5; 95% confidence interval 1.1–5.4). Risk was particularly increased in the period with higher boost irradiation. Patients with left-sided breast cancer had no excess of cardiovascular mortality compared with patients with right-sided tumors.
Radiotherapy of inner-quadrant breast cancer is associated with an important increase of cardiovascular mortality, a possible result of higher irradiation of the heart. For patients with inner-quadrant tumors, the heart should be radioprotected.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdp341</identifier><identifier>PMID: 19703922</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Antineoplastic agents ; Biological and medical sciences ; breast cancer ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; breast quadrant ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - pathology ; cardiovascular mortality ; Female ; Follow-Up Studies ; Gynecology. Andrology. Obstetrics ; Humans ; Lymph Nodes - pathology ; Mammary gland diseases ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Pharmacology. Drug treatments ; population based ; Radiation Injuries - etiology ; Radiation Injuries - mortality ; Radiation Injuries - pathology ; radiotherapy ; Radiotherapy - adverse effects ; Time Factors ; Treatment Outcome ; Tumors</subject><ispartof>Annals of oncology, 2010-03, Vol.21 (3), p.459-465</ispartof><rights>2009 European Society for Medical Oncology</rights><rights>The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org 2010</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-576c7ec2de75ff460ed99340bdde83971aaf53dc6a2229bd96da9cd68f63f1d13</citedby><cites>FETCH-LOGICAL-c476t-576c7ec2de75ff460ed99340bdde83971aaf53dc6a2229bd96da9cd68f63f1d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22585919$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19703922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bouchardy, C.</creatorcontrib><creatorcontrib>Rapiti, E.</creatorcontrib><creatorcontrib>Usel, M.</creatorcontrib><creatorcontrib>Majno, S. Balmer</creatorcontrib><creatorcontrib>Vlastos, G.</creatorcontrib><creatorcontrib>Benhamou, S.</creatorcontrib><creatorcontrib>Miralbell, R.</creatorcontrib><creatorcontrib>Neyroud-Caspar, I.</creatorcontrib><creatorcontrib>Verkooijen, H.M.</creatorcontrib><creatorcontrib>Vinh-Hung, V.</creatorcontrib><title>Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>Radiotherapy of the left breast is associated with higher cardiovascular mortality linked to cardiotoxic effect of irradiation. Radiotherapy of inner quadrants can be associated with greater heart irradiation, but no study has evaluated the effect of inner-quadrant irradiation on cardiovascular mortality.
We identified 1245 women, the majority with breast-conserving surgery, irradiated for primary node-negative breast cancer from 1980 to 2004 registered at the Geneva Cancer Registry. We compared breast cancer-specific and cardiovascular mortality between inner-quadrant (n=393) versus outer-quadrant tumors (n=852) by multivariate Cox regression analysis.
After a mean follow-up of 7.7 years, 28 women died of cardiovascular disease and 91 of breast cancer. Patients with inner-quadrant tumors had a more than doubled risk of cardiovascular mortality compared with patients with outer-quadrant tumors (adjusted hazard ratio 2.5; 95% confidence interval 1.1–5.4). Risk was particularly increased in the period with higher boost irradiation. Patients with left-sided breast cancer had no excess of cardiovascular mortality compared with patients with right-sided tumors.
Radiotherapy of inner-quadrant breast cancer is associated with an important increase of cardiovascular mortality, a possible result of higher irradiation of the heart. For patients with inner-quadrant tumors, the heart should be radioprotected.</description><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>breast cancer</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>breast quadrant</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - pathology</subject><subject>cardiovascular mortality</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Pharmacology. Drug treatments</subject><subject>population based</subject><subject>Radiation Injuries - etiology</subject><subject>Radiation Injuries - mortality</subject><subject>Radiation Injuries - pathology</subject><subject>radiotherapy</subject><subject>Radiotherapy - adverse effects</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0M9rFDEUwPEgit1Wj14lF8HL2PyYSTZHqbUVKoIoiJfwNnkp0Z3MmGSW9r83Mks9iadA-OQl-RLygrM3nBl5DilNyZ2PfpY9f0Q2fFCm27KePyYbZoTs9CD7E3Jayg_GmDLCPCUn3GgmjRAbki_vHJZCp0AdZB-nAxS37CHTccoV9rHeUxindEvT5LFLeAs1HpDuMkKp7UxymOncNjHVQmPO4CNU9DRMmcaUMHe_FvAZUqV1aUPLM_IkwL7g8-N6Rr6-v_xycd3dfLr6cPH2pnO9VrUbtHIanfCohxB6xdAbI3u28x630mgOEAbpnQIhhNl5ozwY59U2KBm45_KMdOtcl6dSMgY75zhCvrec2T_t7NrOru2af7n6edmN6P_qY6wGXh1BawT70P7kYnlwQgzbwXDT3OvVTcv83zuPb4yl4t0DhvzTKi31YK-_fbf98FmLd0LYj83r1WMLd4iYbXGtvEMfM7pq_RT_cdNvXgKtrg</recordid><startdate>20100301</startdate><enddate>20100301</enddate><creator>Bouchardy, C.</creator><creator>Rapiti, E.</creator><creator>Usel, M.</creator><creator>Majno, S. Balmer</creator><creator>Vlastos, G.</creator><creator>Benhamou, S.</creator><creator>Miralbell, R.</creator><creator>Neyroud-Caspar, I.</creator><creator>Verkooijen, H.M.</creator><creator>Vinh-Hung, V.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20100301</creationdate><title>Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors</title><author>Bouchardy, C. ; Rapiti, E. ; Usel, M. ; Majno, S. Balmer ; Vlastos, G. ; Benhamou, S. ; Miralbell, R. ; Neyroud-Caspar, I. ; Verkooijen, H.M. ; Vinh-Hung, V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-576c7ec2de75ff460ed99340bdde83971aaf53dc6a2229bd96da9cd68f63f1d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>breast cancer</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>breast quadrant</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - pathology</topic><topic>cardiovascular mortality</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Lymph Nodes - pathology</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Pharmacology. Drug treatments</topic><topic>population based</topic><topic>Radiation Injuries - etiology</topic><topic>Radiation Injuries - mortality</topic><topic>Radiation Injuries - pathology</topic><topic>radiotherapy</topic><topic>Radiotherapy - adverse effects</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bouchardy, C.</creatorcontrib><creatorcontrib>Rapiti, E.</creatorcontrib><creatorcontrib>Usel, M.</creatorcontrib><creatorcontrib>Majno, S. Balmer</creatorcontrib><creatorcontrib>Vlastos, G.</creatorcontrib><creatorcontrib>Benhamou, S.</creatorcontrib><creatorcontrib>Miralbell, R.</creatorcontrib><creatorcontrib>Neyroud-Caspar, I.</creatorcontrib><creatorcontrib>Verkooijen, H.M.</creatorcontrib><creatorcontrib>Vinh-Hung, V.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bouchardy, C.</au><au>Rapiti, E.</au><au>Usel, M.</au><au>Majno, S. Balmer</au><au>Vlastos, G.</au><au>Benhamou, S.</au><au>Miralbell, R.</au><au>Neyroud-Caspar, I.</au><au>Verkooijen, H.M.</au><au>Vinh-Hung, V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>21</volume><issue>3</issue><spage>459</spage><epage>465</epage><pages>459-465</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>Radiotherapy of the left breast is associated with higher cardiovascular mortality linked to cardiotoxic effect of irradiation. Radiotherapy of inner quadrants can be associated with greater heart irradiation, but no study has evaluated the effect of inner-quadrant irradiation on cardiovascular mortality.
We identified 1245 women, the majority with breast-conserving surgery, irradiated for primary node-negative breast cancer from 1980 to 2004 registered at the Geneva Cancer Registry. We compared breast cancer-specific and cardiovascular mortality between inner-quadrant (n=393) versus outer-quadrant tumors (n=852) by multivariate Cox regression analysis.
After a mean follow-up of 7.7 years, 28 women died of cardiovascular disease and 91 of breast cancer. Patients with inner-quadrant tumors had a more than doubled risk of cardiovascular mortality compared with patients with outer-quadrant tumors (adjusted hazard ratio 2.5; 95% confidence interval 1.1–5.4). Risk was particularly increased in the period with higher boost irradiation. Patients with left-sided breast cancer had no excess of cardiovascular mortality compared with patients with right-sided tumors.
Radiotherapy of inner-quadrant breast cancer is associated with an important increase of cardiovascular mortality, a possible result of higher irradiation of the heart. For patients with inner-quadrant tumors, the heart should be radioprotected.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>19703922</pmid><doi>10.1093/annonc/mdp341</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antineoplastic agents Biological and medical sciences breast cancer Breast Neoplasms - radiotherapy Breast Neoplasms - surgery breast quadrant Cardiovascular Diseases - etiology Cardiovascular Diseases - mortality Cardiovascular Diseases - pathology cardiovascular mortality Female Follow-Up Studies Gynecology. Andrology. Obstetrics Humans Lymph Nodes - pathology Mammary gland diseases Medical sciences Middle Aged Neoplasm Staging Pharmacology. Drug treatments population based Radiation Injuries - etiology Radiation Injuries - mortality Radiation Injuries - pathology radiotherapy Radiotherapy - adverse effects Time Factors Treatment Outcome Tumors |
| title | Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors |
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