Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer
Objectives This study sought to investigate long-term cardiovascular mortality and its relationship to the use of radiotherapy for breast cancer. Background Cardiovascular diseases are among the main long-term complications of radiotherapy, but knowledge is limited regarding long-term risks because...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2011-01, Vol.57 (4), p.445-452 |
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| creator | Bouillon, Kim, MD, MPH Haddy, Nadia, PhD Delaloge, Suzette, MD Garbay, Jean-Remy, MD Garsi, Jerome-Philippe, PhD Brindel, Pauline, MD, PhD Mousannif, Abdeddahir, MSc Lê, Monique G., MD Labbe, Martine, BSc Arriagada, Rodrigo, MD, PhD Jougla, Eric, MD Chavaudra, Jean, PhD Diallo, Ibrahima, PhD Rubino, Carole, MD, PhD de Vathaire, Florent, PhD |
| description | Objectives This study sought to investigate long-term cardiovascular mortality and its relationship to the use of radiotherapy for breast cancer. Background 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, |
| doi_str_mv | 10.1016/j.jacc.2010.08.638 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_546607</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0735109710044852</els_id><sourcerecordid>1017959615</sourcerecordid><originalsourceid>FETCH-LOGICAL-c649t-41b98145e46ee9ee72404b06af904087b96e9dca24566e5e7d6596590fec74133</originalsourceid><addsrcrecordid>eNp9km-L1DAQxoMo3rr6BXwhBRF90zVp8xdEOBc9hRVBz9chTaeavW6zJu3Jfnun7HoH9-IgkDD5zWTmeULIc0ZXjDL5drvaOu9XFcUA1StZ6wdkwYTQZS2MekgWVNWiZNSoM_Ik5y2lVGpmHpOzilWCCS0W5GITh1_lJaRdsXapDfHaZT_1LhVfYxpdH8ZDcd6NkIrvDm_H35Dc_lB0MRUfErg8YtrgIT0ljzrXZ3h22pfk56ePl-vP5ebbxZf1-ab0kpux5KwxmnEBXAIYAFVxyhsqXWcop1o1RoJpvau4kBIEqFYKg4t24BVndb0k5bFu_gv7qbH7FHYuHWx0wZ5CV3gCK7iUOP-SvD7y-xT_TJBHuwvZQ9-7AeKUreZSGyWUQPLNvSRKrgw2w2b05R10G6c04NwW5UeZlZISqepI-RRzTtDdNMvoXE3arZ0NtLOBlmqLBmLSi1PpqdlBe5Py3zEEXp0ANMr1XUL5Q77lai0F1wy5d0cO0I3rAMlmHwCtakMCP9o2hvv7eH8n3fdhCPjiFRwg385rc2Wp_TF_tfmnMUo516Kq_wGY7sum</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1550007766</pqid></control><display><type>article</type><title>Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><source>SWEPUB Freely available online</source><creator>Bouillon, Kim, MD, MPH ; Haddy, Nadia, PhD ; Delaloge, Suzette, MD ; Garbay, Jean-Remy, MD ; Garsi, Jerome-Philippe, PhD ; Brindel, Pauline, MD, PhD ; Mousannif, Abdeddahir, MSc ; Lê, Monique G., MD ; Labbe, Martine, BSc ; Arriagada, Rodrigo, MD, PhD ; Jougla, Eric, MD ; Chavaudra, Jean, PhD ; Diallo, Ibrahima, PhD ; Rubino, Carole, MD, PhD ; de Vathaire, Florent, PhD</creator><creatorcontrib>Bouillon, Kim, MD, MPH ; Haddy, Nadia, PhD ; Delaloge, Suzette, MD ; Garbay, Jean-Remy, MD ; Garsi, Jerome-Philippe, PhD ; Brindel, Pauline, MD, PhD ; Mousannif, Abdeddahir, MSc ; Lê, Monique G., MD ; Labbe, Martine, BSc ; Arriagada, Rodrigo, MD, PhD ; Jougla, Eric, MD ; Chavaudra, Jean, PhD ; Diallo, Ibrahima, PhD ; Rubino, Carole, MD, PhD ; de Vathaire, Florent, PhD</creatorcontrib><description>Objectives This study sought to investigate long-term cardiovascular mortality and its relationship to the use of radiotherapy for breast cancer. Background 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. Methods 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. Results 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 disease 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 increase with a longer follow-up, even after 20 years following radiotherapy.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2010.08.638</identifier><identifier>PMID: 21251585</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Age ; Aged ; Biological and medical sciences ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - mortality ; Breast Neoplasms - radiotherapy ; Cancer Care Facilities ; Cancer therapies ; cardiac disease ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cause of Death ; causes of death ; Chemotherapy, Adjuvant ; Chest ; Cohort Studies ; Female ; Follow-Up Studies ; France ; Gynecology. Andrology. Obstetrics ; Heart ; Heart - radiation effects ; Heart diseases ; Histology ; Humans ; Internal Medicine ; long-term mortality ; long-term risk ; Mammary gland diseases ; Mastectomy, Segmental - methods ; Medical prognosis ; Medical records ; Medical sciences ; Middle Aged ; Mortality ; Multivariate analysis ; Patients ; Radiation Injuries - mortality ; Radiation therapy ; Radiotherapy ; Radiotherapy Dosage ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Assessment ; Risk factors ; Statistical methods ; Surgery ; Survival Analysis ; Time Factors ; Tumors ; Vascular diseases ; Womens health</subject><ispartof>Journal of the American College of Cardiology, 2011-01, Vol.57 (4), p.445-452</ispartof><rights>American College of Cardiology Foundation</rights><rights>2011 American College of Cardiology Foundation</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 25, 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c649t-41b98145e46ee9ee72404b06af904087b96e9dca24566e5e7d6596590fec74133</citedby><cites>FETCH-LOGICAL-c649t-41b98145e46ee9ee72404b06af904087b96e9dca24566e5e7d6596590fec74133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109710044852$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23865481$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21251585$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:122026498$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Bouillon, Kim, MD, MPH</creatorcontrib><creatorcontrib>Haddy, Nadia, PhD</creatorcontrib><creatorcontrib>Delaloge, Suzette, MD</creatorcontrib><creatorcontrib>Garbay, Jean-Remy, MD</creatorcontrib><creatorcontrib>Garsi, Jerome-Philippe, PhD</creatorcontrib><creatorcontrib>Brindel, Pauline, MD, PhD</creatorcontrib><creatorcontrib>Mousannif, Abdeddahir, MSc</creatorcontrib><creatorcontrib>Lê, Monique G., MD</creatorcontrib><creatorcontrib>Labbe, Martine, BSc</creatorcontrib><creatorcontrib>Arriagada, Rodrigo, MD, PhD</creatorcontrib><creatorcontrib>Jougla, Eric, MD</creatorcontrib><creatorcontrib>Chavaudra, Jean, PhD</creatorcontrib><creatorcontrib>Diallo, Ibrahima, PhD</creatorcontrib><creatorcontrib>Rubino, Carole, MD, PhD</creatorcontrib><creatorcontrib>de Vathaire, Florent, PhD</creatorcontrib><title>Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives This study sought to investigate long-term cardiovascular mortality and its relationship to the use of radiotherapy for breast cancer. Background 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. Methods 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. Results 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 disease 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 increase with a longer follow-up, even after 20 years following radiotherapy.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Cancer Care Facilities</subject><subject>Cancer therapies</subject><subject>cardiac disease</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cause of Death</subject><subject>causes of death</subject><subject>Chemotherapy, Adjuvant</subject><subject>Chest</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>France</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Heart</subject><subject>Heart - radiation effects</subject><subject>Heart diseases</subject><subject>Histology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>long-term mortality</subject><subject>long-term risk</subject><subject>Mammary gland diseases</subject><subject>Mastectomy, Segmental - methods</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Radiation Injuries - mortality</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Adjuvant</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Statistical methods</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Tumors</subject><subject>Vascular diseases</subject><subject>Womens health</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9km-L1DAQxoMo3rr6BXwhBRF90zVp8xdEOBc9hRVBz9chTaeavW6zJu3Jfnun7HoH9-IgkDD5zWTmeULIc0ZXjDL5drvaOu9XFcUA1StZ6wdkwYTQZS2MekgWVNWiZNSoM_Ik5y2lVGpmHpOzilWCCS0W5GITh1_lJaRdsXapDfHaZT_1LhVfYxpdH8ZDcd6NkIrvDm_H35Dc_lB0MRUfErg8YtrgIT0ljzrXZ3h22pfk56ePl-vP5ebbxZf1-ab0kpux5KwxmnEBXAIYAFVxyhsqXWcop1o1RoJpvau4kBIEqFYKg4t24BVndb0k5bFu_gv7qbH7FHYuHWx0wZ5CV3gCK7iUOP-SvD7y-xT_TJBHuwvZQ9-7AeKUreZSGyWUQPLNvSRKrgw2w2b05R10G6c04NwW5UeZlZISqepI-RRzTtDdNMvoXE3arZ0NtLOBlmqLBmLSi1PpqdlBe5Py3zEEXp0ANMr1XUL5Q77lai0F1wy5d0cO0I3rAMlmHwCtakMCP9o2hvv7eH8n3fdhCPjiFRwg385rc2Wp_TF_tfmnMUo516Kq_wGY7sum</recordid><startdate>20110125</startdate><enddate>20110125</enddate><creator>Bouillon, Kim, MD, MPH</creator><creator>Haddy, Nadia, PhD</creator><creator>Delaloge, Suzette, MD</creator><creator>Garbay, Jean-Remy, MD</creator><creator>Garsi, Jerome-Philippe, PhD</creator><creator>Brindel, Pauline, MD, PhD</creator><creator>Mousannif, Abdeddahir, MSc</creator><creator>Lê, Monique G., MD</creator><creator>Labbe, Martine, BSc</creator><creator>Arriagada, Rodrigo, MD, PhD</creator><creator>Jougla, Eric, MD</creator><creator>Chavaudra, Jean, PhD</creator><creator>Diallo, Ibrahima, PhD</creator><creator>Rubino, Carole, MD, PhD</creator><creator>de Vathaire, Florent, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</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><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20110125</creationdate><title>Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer</title><author>Bouillon, Kim, MD, MPH ; Haddy, Nadia, PhD ; Delaloge, Suzette, MD ; Garbay, Jean-Remy, MD ; Garsi, Jerome-Philippe, PhD ; Brindel, Pauline, MD, PhD ; Mousannif, Abdeddahir, MSc ; Lê, Monique G., MD ; Labbe, Martine, BSc ; Arriagada, Rodrigo, MD, PhD ; Jougla, Eric, MD ; Chavaudra, Jean, PhD ; Diallo, Ibrahima, PhD ; Rubino, Carole, MD, PhD ; de Vathaire, Florent, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c649t-41b98145e46ee9ee72404b06af904087b96e9dca24566e5e7d6596590fec74133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Cancer Care Facilities</topic><topic>Cancer therapies</topic><topic>cardiac disease</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cause of Death</topic><topic>causes of death</topic><topic>Chemotherapy, Adjuvant</topic><topic>Chest</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Heart</topic><topic>Heart - radiation effects</topic><topic>Heart diseases</topic><topic>Histology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>long-term mortality</topic><topic>long-term risk</topic><topic>Mammary gland diseases</topic><topic>Mastectomy, Segmental - methods</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Patients</topic><topic>Radiation Injuries - mortality</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Adjuvant</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Statistical methods</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Tumors</topic><topic>Vascular diseases</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bouillon, Kim, MD, MPH</creatorcontrib><creatorcontrib>Haddy, Nadia, PhD</creatorcontrib><creatorcontrib>Delaloge, Suzette, MD</creatorcontrib><creatorcontrib>Garbay, Jean-Remy, MD</creatorcontrib><creatorcontrib>Garsi, Jerome-Philippe, PhD</creatorcontrib><creatorcontrib>Brindel, Pauline, MD, PhD</creatorcontrib><creatorcontrib>Mousannif, Abdeddahir, MSc</creatorcontrib><creatorcontrib>Lê, Monique G., MD</creatorcontrib><creatorcontrib>Labbe, Martine, BSc</creatorcontrib><creatorcontrib>Arriagada, Rodrigo, MD, PhD</creatorcontrib><creatorcontrib>Jougla, Eric, MD</creatorcontrib><creatorcontrib>Chavaudra, Jean, PhD</creatorcontrib><creatorcontrib>Diallo, Ibrahima, PhD</creatorcontrib><creatorcontrib>Rubino, Carole, MD, PhD</creatorcontrib><creatorcontrib>de Vathaire, Florent, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</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><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bouillon, Kim, MD, MPH</au><au>Haddy, Nadia, PhD</au><au>Delaloge, Suzette, MD</au><au>Garbay, Jean-Remy, MD</au><au>Garsi, Jerome-Philippe, PhD</au><au>Brindel, Pauline, MD, PhD</au><au>Mousannif, Abdeddahir, MSc</au><au>Lê, Monique G., MD</au><au>Labbe, Martine, BSc</au><au>Arriagada, Rodrigo, MD, PhD</au><au>Jougla, Eric, MD</au><au>Chavaudra, Jean, PhD</au><au>Diallo, Ibrahima, PhD</au><au>Rubino, Carole, MD, PhD</au><au>de Vathaire, Florent, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2011-01-25</date><risdate>2011</risdate><volume>57</volume><issue>4</issue><spage>445</spage><epage>452</epage><pages>445-452</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives This study sought to investigate long-term cardiovascular mortality and its relationship to the use of radiotherapy for breast cancer. Background 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. Methods 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. Results 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 disease 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 increase with a longer follow-up, even after 20 years following radiotherapy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21251585</pmid><doi>10.1016/j.jacc.2010.08.638</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Aged Biological and medical sciences Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - mortality Breast Neoplasms - radiotherapy Cancer Care Facilities Cancer therapies cardiac disease Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - etiology Cardiovascular Diseases - mortality Cause of Death causes of death Chemotherapy, Adjuvant Chest Cohort Studies Female Follow-Up Studies France Gynecology. Andrology. Obstetrics Heart Heart - radiation effects Heart diseases Histology Humans Internal Medicine long-term mortality long-term risk Mammary gland diseases Mastectomy, Segmental - methods Medical prognosis Medical records Medical sciences Middle Aged Mortality Multivariate analysis Patients Radiation Injuries - mortality Radiation therapy Radiotherapy Radiotherapy Dosage Radiotherapy, Adjuvant Retrospective Studies Risk Assessment Risk factors Statistical methods Surgery Survival Analysis Time Factors Tumors Vascular diseases Womens health |
| title | Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer |
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