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Risk of coronary stenosis after adjuvant radiotherapy for breast cancer
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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217856/ https://www.ncbi.nlm.nih.gov/pubmed/35389076 http://dx.doi.org/10.1007/s00066-022-01927-0 |
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author | Wennstig, A.-K. Garmo, H. Wadsten, L. Lagerqvist, B. Fredriksson, I. Holmberg, L. Blomqvist, C. Nilsson, G. Sund, M. |
author_facet | Wennstig, A.-K. Garmo, H. Wadsten, L. Lagerqvist, B. Fredriksson, I. Holmberg, L. Blomqvist, C. Nilsson, G. Sund, M. |
author_sort | Wennstig, A.-K. |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s00066-022-01927-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-9217856 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-92178562022-06-24 Risk of coronary stenosis after adjuvant radiotherapy for breast cancer Wennstig, A.-K. Garmo, H. Wadsten, L. Lagerqvist, B. Fredriksson, I. Holmberg, L. Blomqvist, C. Nilsson, G. Sund, M. Strahlenther Onkol Original Article 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. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s00066-022-01927-0) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2022-04-07 2022 /pmc/articles/PMC9217856/ /pubmed/35389076 http://dx.doi.org/10.1007/s00066-022-01927-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Wennstig, A.-K. Garmo, H. Wadsten, L. Lagerqvist, B. Fredriksson, I. Holmberg, L. Blomqvist, C. Nilsson, G. Sund, M. Risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
title | Risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
title_full | Risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
title_fullStr | Risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
title_full_unstemmed | Risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
title_short | Risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
title_sort | risk of coronary stenosis after adjuvant radiotherapy for breast cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217856/ https://www.ncbi.nlm.nih.gov/pubmed/35389076 http://dx.doi.org/10.1007/s00066-022-01927-0 |
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