Radiation-related heart disease after breast cancer radiation therapy in Korean women

Korean Breast Cancer Society

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To study the late cardiac toxicity of breast radiation therapy (RT) in Asian women. Methods: Female breast cancer patients in Korea who underwent breast conservation surgery followed by RT from 1990–2012 were identified from two large registries at institution and population levels. Cumulative incidences of acute coronary events (ACE) or cardiac mortality were estimated in relation to the laterality of breast cancer using a competing risks analysis. Results: In an analysis of 2577 women from a single institution, 3.7% were obese (body mass index ≥30), and 3.4% were ever-smokers. Patients with a history of hypertension, diabetes, or coronary artery disease were 17.5, 5.7, and 2.8%, respectively. The mean heart doses were 6.2 and 1.5 Gy for left- and right-sided tumors, respectively. With a median follow-up of 7 (range 1–23) years, the overall and breast cancer-specific survivals at 10 years were 94.9 and 96.5%, respectively. The 10-year cumulative incidence of ACE was 2.96%. The mean time to ACE was 5.2 ± 3.9 years (range 1–17). There was no clinically relevant difference in rates of ACE between left-sided and right-sided patients, with an adjusted hazard ratio of 1.16 (CI 0.59–2.29). An analysis of 24,235 women in a nationwide registry validated these negative findings with respect to cardiac mortality, with an adjusted hazard ratio of 1.52 (CI 0.37–6.25). Increasing age, a higher body mass index, and a history of hypertension or ischemic heart disease were identified as risk factors. Conclusions: Our findings reassure that excess risk from breast RT may be small in healthy women, most of who not smoke, weigh less, and have fewer risk factors. A validation using a larger data set of National Health Insurance Corporation is ongoing.

Original languageEnglish
Pages (from-to)249-257
Number of pages9
JournalBreast Cancer Research and Treatment
Volume166
Issue number1
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Heart Diseases
Radiotherapy
Radiation
Breast Neoplasms
Breast
Registries
Body Mass Index
Hypertension
Mortality
Incidence
National Health Programs
Patient Rights
Korea
Smoke
Myocardial Ischemia
Coronary Artery Disease
Survival
Population
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@article{51252b060b7e4f46b9d445bda6165f6a,
title = "Radiation-related heart disease after breast cancer radiation therapy in Korean women",
abstract = "Purpose: To study the late cardiac toxicity of breast radiation therapy (RT) in Asian women. Methods: Female breast cancer patients in Korea who underwent breast conservation surgery followed by RT from 1990–2012 were identified from two large registries at institution and population levels. Cumulative incidences of acute coronary events (ACE) or cardiac mortality were estimated in relation to the laterality of breast cancer using a competing risks analysis. Results: In an analysis of 2577 women from a single institution, 3.7{\%} were obese (body mass index ≥30), and 3.4{\%} were ever-smokers. Patients with a history of hypertension, diabetes, or coronary artery disease were 17.5, 5.7, and 2.8{\%}, respectively. The mean heart doses were 6.2 and 1.5 Gy for left- and right-sided tumors, respectively. With a median follow-up of 7 (range 1–23) years, the overall and breast cancer-specific survivals at 10 years were 94.9 and 96.5{\%}, respectively. The 10-year cumulative incidence of ACE was 2.96{\%}. The mean time to ACE was 5.2 ± 3.9 years (range 1–17). There was no clinically relevant difference in rates of ACE between left-sided and right-sided patients, with an adjusted hazard ratio of 1.16 (CI 0.59–2.29). An analysis of 24,235 women in a nationwide registry validated these negative findings with respect to cardiac mortality, with an adjusted hazard ratio of 1.52 (CI 0.37–6.25). Increasing age, a higher body mass index, and a history of hypertension or ischemic heart disease were identified as risk factors. Conclusions: Our findings reassure that excess risk from breast RT may be small in healthy women, most of who not smoke, weigh less, and have fewer risk factors. A validation using a larger data set of National Health Insurance Corporation is ongoing.",
author = "{Korean Breast Cancer Society} and Chang, {Jee Suk} and Ko, {Byung Kyun} and Bae, {Jeoung Won} and Yu, {Jong Han} and Park, {Min Ho} and Yongsik Jung and Jeon, {Ye Won} and Kim, {Kyung Hwan} and Jaeyong Shin and Suh, {Chang Ok} and Kim, {Yong Bae}",
year = "2017",
month = "11",
day = "1",
doi = "10.1007/s10549-017-4398-y",
language = "English",
volume = "166",
pages = "249--257",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "1",

}

Radiation-related heart disease after breast cancer radiation therapy in Korean women. / Korean Breast Cancer Society.

In: Breast Cancer Research and Treatment, Vol. 166, No. 1, 01.11.2017, p. 249-257.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Radiation-related heart disease after breast cancer radiation therapy in Korean women

AU - Korean Breast Cancer Society

AU - Chang, Jee Suk

AU - Ko, Byung Kyun

AU - Bae, Jeoung Won

AU - Yu, Jong Han

AU - Park, Min Ho

AU - Jung, Yongsik

AU - Jeon, Ye Won

AU - Kim, Kyung Hwan

AU - Shin, Jaeyong

AU - Suh, Chang Ok

AU - Kim, Yong Bae

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Purpose: To study the late cardiac toxicity of breast radiation therapy (RT) in Asian women. Methods: Female breast cancer patients in Korea who underwent breast conservation surgery followed by RT from 1990–2012 were identified from two large registries at institution and population levels. Cumulative incidences of acute coronary events (ACE) or cardiac mortality were estimated in relation to the laterality of breast cancer using a competing risks analysis. Results: In an analysis of 2577 women from a single institution, 3.7% were obese (body mass index ≥30), and 3.4% were ever-smokers. Patients with a history of hypertension, diabetes, or coronary artery disease were 17.5, 5.7, and 2.8%, respectively. The mean heart doses were 6.2 and 1.5 Gy for left- and right-sided tumors, respectively. With a median follow-up of 7 (range 1–23) years, the overall and breast cancer-specific survivals at 10 years were 94.9 and 96.5%, respectively. The 10-year cumulative incidence of ACE was 2.96%. The mean time to ACE was 5.2 ± 3.9 years (range 1–17). There was no clinically relevant difference in rates of ACE between left-sided and right-sided patients, with an adjusted hazard ratio of 1.16 (CI 0.59–2.29). An analysis of 24,235 women in a nationwide registry validated these negative findings with respect to cardiac mortality, with an adjusted hazard ratio of 1.52 (CI 0.37–6.25). Increasing age, a higher body mass index, and a history of hypertension or ischemic heart disease were identified as risk factors. Conclusions: Our findings reassure that excess risk from breast RT may be small in healthy women, most of who not smoke, weigh less, and have fewer risk factors. A validation using a larger data set of National Health Insurance Corporation is ongoing.

AB - Purpose: To study the late cardiac toxicity of breast radiation therapy (RT) in Asian women. Methods: Female breast cancer patients in Korea who underwent breast conservation surgery followed by RT from 1990–2012 were identified from two large registries at institution and population levels. Cumulative incidences of acute coronary events (ACE) or cardiac mortality were estimated in relation to the laterality of breast cancer using a competing risks analysis. Results: In an analysis of 2577 women from a single institution, 3.7% were obese (body mass index ≥30), and 3.4% were ever-smokers. Patients with a history of hypertension, diabetes, or coronary artery disease were 17.5, 5.7, and 2.8%, respectively. The mean heart doses were 6.2 and 1.5 Gy for left- and right-sided tumors, respectively. With a median follow-up of 7 (range 1–23) years, the overall and breast cancer-specific survivals at 10 years were 94.9 and 96.5%, respectively. The 10-year cumulative incidence of ACE was 2.96%. The mean time to ACE was 5.2 ± 3.9 years (range 1–17). There was no clinically relevant difference in rates of ACE between left-sided and right-sided patients, with an adjusted hazard ratio of 1.16 (CI 0.59–2.29). An analysis of 24,235 women in a nationwide registry validated these negative findings with respect to cardiac mortality, with an adjusted hazard ratio of 1.52 (CI 0.37–6.25). Increasing age, a higher body mass index, and a history of hypertension or ischemic heart disease were identified as risk factors. Conclusions: Our findings reassure that excess risk from breast RT may be small in healthy women, most of who not smoke, weigh less, and have fewer risk factors. A validation using a larger data set of National Health Insurance Corporation is ongoing.

UR - http://www.scopus.com/inward/record.url?scp=85024472192&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85024472192&partnerID=8YFLogxK

U2 - 10.1007/s10549-017-4398-y

DO - 10.1007/s10549-017-4398-y

M3 - Article

C2 - 28717853

AN - SCOPUS:85024472192

VL - 166

SP - 249

EP - 257

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 1

ER -