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Open Access 01-08-2018 | Clinical trial

Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ

Authors: C. Wadsten, A.-K. Wennstig, H. Garmo, Greger Nilsson, Carl Blomqvist, Lars Holmberg, Irma Fredriksson, F. Wärnberg, M. Sund

Published in: Breast Cancer Research and Treatment | Issue 1/2018

Abstract

Purpose

The use of adjuvant radiotherapy (RT) in the management of ductal carcinoma in situ (DCIS) is increasing. Left-sided breast irradiation may involve exposure of the heart to ionising radiation, increasing the risk of ischemic heart disease (IHD). We examined the incidence of IHD in a population-based cohort of women with DCIS.

Methods

The Breast Cancer DataBase Sweden (BCBase) cohort includes women registered with invasive and in situ breast cancers 1992–2012 and age-matched women without a history of breast cancer. In this analysis, 6270 women with DCIS and a comparison cohort of 31,257 women were included. Through linkage with population-based registers, data on comorbidity, socioeconomic status and incidence of IHD was obtained. Hazard ratios (HR) for IHD with 95% confidence intervals (CI) were analysed.

Results

Median follow-up time was 8.8 years. The risk of IHD was not increased for women with DCIS versus women in the comparison cohort (HR 0.93; 95% CI 0.82–1.06), after treatment with radiotherapy versus surgery alone (HR 0.77; 95% CI 0.60–0.98) or when analysing RT by laterality (HR 0.85; 95% CI 0.53–1.37 for left-sided versus right-sided RT).

Conclusions

The risk of IHD was lower for women with DCIS allocated to RT compared to non-irradiated women and to the comparison cohort, probably due to patient selection. Comparison of RT by laterality did not show any over-risk for irradiation of the left breast.

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Title: Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ
Authors: C. Wadsten
A.-K. Wennstig
H. Garmo
Greger Nilsson
Carl Blomqvist
Lars Holmberg
Irma Fredriksson
F. Wärnberg
M. Sund
Publication date: 01-08-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-4803-1

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