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Radiation therapy for breast cancer can pose long-term heart risks

By Amy Norton HealthDay Reporter

WEDNESDAY, 22 September 2021 (HealthDay News) – Younger women undergoing radiation an increased risk of cancer in the left breast heart disease years later, find a new study.

Among women who have received radiation therapy for leftists breast cancer, 10.5% developed coronary heart disease over the next 27 years, researchers found. This was almost double the rate among women who had radiation to tumors in the right breast.

Experts said the findings, recently published in the Journal of the American College of Cardiology: CardioOncology, is not unexpected.

Due to the anatomical position of the heart, the organ and its butcher is exposed to more radiation when a woman receives treatment for cancer of the left breast.

And previous studies have found that women do have a higher long-term coronary artery disease compared to women who receive treatment on the right breast.

But the new study focuses on younger women, diagnosed before the age of 55, says researcher Gordon Watt, a postdoctoral fellow at Memorial Sloan Kettering Cancer Center in New York.

These women will probably live many more years after their lives breast cancer treatment, therefore, it is important to understand what kind of long-term follow-up they will need for their overall health, according to Watt.

He stressed that it is not the goal to deter women from receiving radiation therapy.

“Radiation is an important component of breast cancer treatment, and this study is not about whether women should receive it,” Watt said. “It’s about what kind of follow-up they may need afterwards.”

The study included 972 women who received radiation for phase 1 or stage 2 breast cancer between 1985 and 2008.

For more than 27 years, 10.5% of women who received left-sided radiation also developed coronary artery disease. chest pain need medication, clogged heart veins or a heart attack. This compares with 5.8% of women who received irradiated radiation.

Among women younger than 40 when their breast cancer was diagnosed, 5.9% of those who received left-sided radiation eventually developed heart disease. This compared to none of those who had legal radiation.

Overall, Watt said, women who receive right-sided radiation have a heart disease rate similar to that seen among American women in general.

The bottom line, according to Watt, is that doctors need to consider the ‘laterality’ or side of their cancer when caring for breast cancer survivors.

“Left-sided radiation should be considered a risk factor for coronary artery disease,” Watt said.

However, he also noted that although the radiation on the left side was associated with a relatively higher risk, most women in the study did not develop any coronary artery disease.

What does long-term follow-up for heart disease involve?

There is no fixed way to do this, according to dr. Louis Constine, a radiation oncologist at the University of Rochester’s Winship Cancer Institute in Rochester, NY

“We do not know what optimal supervision is,” says Constine, co-author of a main article published with the study. “We still have to define what the best method is, how often it should be done and for how long.”

As it currently stands, breast cancer survivors differ in how their heart health is monitored. For example, if they were treated at a major academic medical center, Constine said they might see a cardio-oncologist-cardiologist who specializes in the heart health of cancer survivors.

Other women may see their primary care physician. Both Constine and Watt said a woman’s doctor should know her history of cancer treatment.

As for their personal risk for coronary artery disease, individual women will differ, Constine said: Traditional risk factors, such as smoking, high blood pressure, obesity and diabetes, are crucial – just like for people who have never had cancer.

“Try to reduce your risk by living a healthy life, with regular exercise, a healthy diet and no smoking,” Constine said.

Another important point, Watt said, is that women in this study were treated largely in the 1980s and 90s. Modern radiation has changed in ways specifically designed to protect the heart.

Constine said that current techniques — involving changes in the radiation itself, and tactics such as breathing — have limited the amount of radiation that reaches the heart and its arteries.

According to him, it is not yet known how it will affect the survivors’ long-term risk of coronary artery disease.

More information

The American Heart Association has more on this breast cancer and heart disease.

SOURCES: Gordon Watt, PhD, Postdoctoral Research Fellow, Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York City; Louis Constine, MD, Professor, Radiation Oncology, Winship Cancer Institute, University of Rochester, Rochester, NY; Journal of the American College of Cardiology: CardioOncology, September 2021

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