A nested case-control study on radiation dose-response for cardiac events in breast cancer patients in Germany

Baaken, Dan; Merzenich, Hiltrud; Schmidt, Marcus; Bekes, Inga; Schwentner, Lukas; Janni, Wolfgang; Woeckel, Achim; Mayr, Manfred; Mose, Stephan; Merz, Thomas; Ghilescu, Voica; Renner, Jona; Bartkowiak, Detlef; Wiegel, Thomas; Blettner, Maria; Schmidberger, Heinz; Wollschläger, Daniel

doi:10.1016/j.breast.2022.05.007

Cited by 10 publications

(8 citation statements)

References 36 publications

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“…Since our results were obtained from analysis of data for patients in a later period, it is not surprising that cardiac-related deaths have not increased with radiotherapy. Our results for Asian or Pacific islander patients are supported by results of recent studies in which tumor laterality was used as a surrogate of heart-irradiated dose, showing no significantly increased risk for cardiac late effects for more recent treatment periods (7).…”

Section: Discussionsupporting

confidence: 87%

Recent Postoperative Radiotherapy for Left-sided Breast Cancer Does Not Increase Mortality of Heart Disease in Asians or Pacific Islanders: SEER Database Analysis

Jingu¹,

Umezawa²,

Yamamoto³

et al. 2023

Anticancer Res

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Background/Aim: The purpose of this study was to evaluate the impact of recent radiotherapy on mortality from heart disease in Asians or Pacific islanders with breast cancer using the Surveillance, Epidemiology, and End Results (SEER) database. Patients and Methods: Asians or Pacific islanders with stage 0 or I (AJCC 6th) breast cancer between 2000 and 2015 were analyzed. The impact of radiotherapy for mortality from heart disease after treatment was evaluated by comparing patients who received radiotherapy for left-sided breast cancer, patients who received radiotherapy for right-sided breast cancer and patients who did not receive radiotherapy. Results: In 25,684 Asians or Pacific islanders, the incidence of cardiac death was higher in patients who did not receive radiotherapy than in patients who received radiotherapy. Among patients who received external beam irradiation, the incidence of cardiac death was 2.00% for patients with left-sided breast cancer and 1.69% for patients with right-sided breast cancer, with no significant difference (chi-square test, p=0.427). In the period from 2000 to 2008, there was no significant difference between the cumulative heart-related death rates in patients who received radiotherapy and in patients who did not receive radiotherapy (Tarone-Ware test, p=0.406); however, in 2009-2015, the cumulative heart-related death rate in patients who did not receive radiotherapy was significantly higher than that in patients who received radiotherapy (logrank test, p<0.001). Conclusion: Heart-related death after treatment for breast cancer is relatively rare in Asians or Pacific islanders. Since at least 2000, the cardiac impact of postoperative radiotherapy has not been significant.

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Section: Discussionsupporting

confidence: 87%

Recent Postoperative Radiotherapy for Left-sided Breast Cancer Does Not Increase Mortality of Heart Disease in Asians or Pacific Islanders: SEER Database Analysis

Jingu¹,

Umezawa²,

Yamamoto³

et al. 2023

Anticancer Res

View full text Add to dashboard Cite

show abstract

“…Since our results were obtained from analysis of data for patients after in a later period, it is not surprising that cardiac-related deaths have not increased with radiotherapy. Our results for Asian or Paci c islander patients are supported by results of recent studies in which tumor laterality was used as a surrogate of heart-irradiated dose, showing no signi cantly increased risk for cardiac late effects for more recent treatment periods (7).…”

Section: Discussionsupporting

confidence: 87%

Recent postoperative radiotherapy for left-sided breast cancer does not increase mortality of heart disease in Asians or Pacific islanders: SEER database analysis

Jingu

Umezawa

Yamamoto

et al. 2023

Preprint

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Background Radiation-induced heart damage has recently attracted attention, and serious heart damage due to radiation has been reported in patients with breast cancer. The purpose of this study was to evaluate the impact of radiotherapy on mortality from heart disease in Asians or Pacific islanders with breast cancer using the Surveillance, Epidemiology, and End Results (SEER) database. Methods Asians or Pacific islanders with stage 0 or I (AJCC 6th ) breast cancer between 2000 and 2015 were analyzed. The impact of radiotherapy for mortality from heart disease after treatment was evaluated by comparing patients who received radiotherapy for left-sided breast cancer, patients who received radiotherapy for right-sided breast cancer and patients who did not receive radiotherapy Results In 25,684 Asians or Pacific islanders, the incidence of cardiac death was higher in patients who did not receive radiotherapy than in patients who received radiotherapy. Among patients who received external beam irradiation, the incidences of cardiac death were 2.00% for patients with left-sided breast cancer and 1.69% for patients with right-sided breast cancer, with no significant difference (chi-square test, p = 0.427). In the period from 2000 to 2008, there was no significant difference between the cumulative heart-related death rates in patients who received radiotherapy and in patients who did not receive radiotherapy (Tarone-Ware test, p = 0.406); however, in 2009–2015, the cumulative heart-related death rate in patients who did not receive radiotherapy was significantly higher than that in patients who received radiotherapy (log-rank test, p < 0.001). Conclusions Heart-related death after treatment for breast cancer is relatively rare in Asians or Pacific islanders. Since at least 2000, the cardiac impact of postoperative radiotherapy has not been significant.

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“…Two large studies found cardiac complication were related to the estimated mean heart dose. 25,26 However, a dose-response effect was not seen in a small study from South Korea 27 or case-control studies from British Columbia, Germany, and Denmark, [28][29][30] although such a relation was found in a single-institution study from Seoul 31 and in a case-control study from Denmark. 32 One study suggested dose to coronary arteries is more predictive of risk than mean heart dose, 33 but this was not confirmed in another study.…”

mentioning

confidence: 98%

Internal Mammary Node Irradiation Debate: Case Closed? Not Yet, and Maybe Never

Recht

2024

JCO

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A nested case-control study on radiation dose-response for cardiac events in breast cancer patients in Germany

Cited by 10 publications

References 36 publications

Recent Postoperative Radiotherapy for Left-sided Breast Cancer Does Not Increase Mortality of Heart Disease in Asians or Pacific Islanders: SEER Database Analysis

Recent Postoperative Radiotherapy for Left-sided Breast Cancer Does Not Increase Mortality of Heart Disease in Asians or Pacific Islanders: SEER Database Analysis

Recent postoperative radiotherapy for left-sided breast cancer does not increase mortality of heart disease in Asians or Pacific islanders: SEER database analysis

Internal Mammary Node Irradiation Debate: Case Closed? Not Yet, and Maybe Never

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