Cardiovascular disease mortality risk defined for breast RT patients
Breast cancer survivors who were treated with radiotherapy (RT) before 1979 have an elevated risk of cardiovascular disease (CVD) mortality, study findings indicate, but this excess is not apparent in patients diagnosed later.
Flora van Leeuwne, from The Netherlands Cancer Institute in Amsterdam, and colleagues report their findings in the International Journal of Radiation Oncology Biology Physics after studying 7425 women treated for early breast cancer between 1970 and 1986.
Follow-up until January 2000 was complete for a total of 94% women, by which time 4160 of the women had died, 76% of whom died from breast cancer.
The team calculated treatment-specific standardized mortality ratios (SMRs) for the patients, compared with data for women in the general population.
The SMR for second malignancies was slightly elevated in women with breast cancer, at 1.2.
Importantly, RT was associated with a 1.7-fold increased risk of CVD-related mortality compared with surgery. Specifically, while post-lumpectomy RT was not associated with an overall increased risk of CVD-related mortality, compared with the general population, women who received RT after mastectomy before 1979 or between 1979 and 1986 had 2.0-fold and 1.5-fold increased risks, respectively.
Women treated with RT before the age of 45 years were found to have an increased risk of death from solid tumors and CVD (SMR=2.0 for both).
"Currently, a large population of breast cancer survivors is at increased risk of death from CVDs and second cancers, especially when treated with RT at a young age," the authors summarize.
Reassuringly, however, they add: "Patients irradiated after 1979 experience low (postmastectomy RT) or no (postlumpectomy RT) excess mortality from CVD."
Int J Rad Oncol Biol Physics 2006; 64:1081–1091
http://www.redjournal.org/article/PI...29457/abstract
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