Thursday, March 14, 2013

Breast Radiation and the Heart

 
Undergoing breast cancer treatment can be a harrowing experience.  Some women who face radiation therapy worry about short and long term side effects like nausea, fatigue, skin problems or changes to the heart and lungs.  Now a new study provides more information about how radiation treatment can influence a woman's chances of developing heart disease.
From The New York Times
  Radiation treatment for breast cancer can increase a woman’s risk of heart disease, doctors have long known. But the size of the added risk has not been clear.
Now, a new study offers a way to estimate the risk. It finds that for most women the risk is modest, and that it is outweighed by the benefit from the treatment, which can halve the recurrence rate and lower the death rate from breast cancer by about one-sixth.
According to the study, a 50-year-old woman with no cardiovascular risk factors has a 1.9 percent chance of dying of heart disease before she turns 80. Radiation treatment for breast cancer would increase that risk to between 2.4 percent and 3.4 percent, depending on how much radiation hits the heart.
“It would be a real tragedy if this put women off having radiotherapy for breast cancer,” said Sarah Darby, a professor of medical statistics at the University of Oxford in Britain, and the lead author of the study, published Wednesday in The New England Journal of Medicine.
   Dr. Darby’s study is based on the records of 2,168 women who had radiation for breast cancer from 1958 to 2001 in Sweden and Denmark; 963 of the women had “major cardiac events” sometime after their cancer treatment, meaning a heart attack or clogged coronary arteries that needed treatment or caused death.
From the treatment records, the researchers estimated the radiation dose to the women’s hearts. They found that the risk began to increase within a few years after exposure, and that it continued for at least 20 years. The higher the dose, the higher the risk, and there was some increase in risk at even the lowest level of exposure.
“It was certainly a surprise to us that the risk started within the first few years after exposure, as radiation-related heart disease has traditionally been thought of as usually occurring several decades after exposure,” Dr. Darby said.
  To read more about the study click here:  http://www.nejm.org/doi/full/10.1056/NEJMoa1209825

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