Magnetic Resonance Imaging Evaluation of Incidental Cardiac Irradiation During Left Breast Cancer Radiotherapy: A Systematic Review

Abstract

Breast cancer is one of the most common malignant tumours among women. Radiotherapy plays a key role in the management of breast cancer patients. However, radiotherapy results in incidental exposure of the heart. This work systematically reviewed articles on magnetic resonance imaging (MRI) evaluation of cardiac changes due to incidental cardiac irradiation during left breast radiotherapy and also to identify the MRI sequences used during evaluation. A systematic literature search was conducted in the following three selected databases: PubMed, ScienceDirect and Scopus using carefully defined search terms related to the left breast, MRI and cardiac irradiation. The quality of the included papers was determined using the critical appraisal skills programme for qualitative studies. The review had a total of six articles that were screened and graded for quality. Articles graded as high and moderate in terms of quality assessment were included and characterised based on the sample size, type of cancer treated, treatment methods employed, and period MRI was performed after radiotherapy. The review showed that breast cancer patients who had radiotherapy also developed radiation-induced heart disease (RIHD) few months post treatment. The review noted that breast cancer patients receiving radiation treatment are at high risk of RIHD which may affect their quality of life after completion of treatment. Cardiac MRI facilitates early detection of RIHD, hence better patient management.