Radiation therapy is an important part of treatment for many women with breast cancer. Like many cancer treatments, the side effects can be just as bothersome and scary as the cancer.
The study reviewed here shows that women who got radiation therapy for breast cancer between 1970 and 1986 had a greater risk (about two to three times higher) of heart problems than women who didn't get radiation therapy. The heart problems included heart attack, heart failure, and heart valve problems. The risk of heart problems was higher because the heart and sometimes the tissue surrounding the breast were exposed to radiation that was intended for the breast cancer. Smoking as well as getting chemotherapy seemed to add to the increased risk from radiation therapy.
Still, it's VERY IMPORTANT to note that this study looked at women who got radiation therapy in the 1970s and 1980s. Today, advances in technology make the heart and surrounding breast tissue much less likely to be exposed to radiation.
Computers now are used to plan radiation treatment that is extremely precise. The computer aims just the right amount of radiation only at tissue that needs to be treated. Other new technology gives your radiation oncologist a wider and safer choice of radiation energy sources. Together, these two advances give your radiation oncologist the ability to avoid exposing your heart to radiation intended for the breast area. Some radiation therapy equipment tracks heart beats and the movement of your lungs and effectively blocks those tissues from any radiation exposure.
If radiation therapy is part of your treatment plan, ask your radiation oncologist if the technology being used is up-to-date. Talk to your radiation therapy treatment team about how they'll make sure that you get only the radiation therapy required to effectively treat the breast cancer.
Visit the breastcancer.org Radiation section to learn more about how radiation therapy works, its risks and side effects.
NEW YORK (Reuters Health) - As a treatment for breast cancer, radiation, even modern regimens, appears to increase the risk of cardiovascular disease, according to a report in the Journal of the National Cancer Institute for March 7.
Earlier reports have indicated that radiotherapy regimens used in the 1970s elevate heart disease risk, but it has been less clear if more recent regimens also increase the risk.
Apart from the "clear benefits" of radiotherapy, doctors should still be aware of the potentially increased risk of cardiovascular disease following specific radiotherapy regimens in long-term breast cancer survivors, Dr. Flora E. van Leeuwen, from the Netherlands Cancer Institute in Amsterdam, and colleagues note in the report.
They evaluated 4,414 women with breast cancer who survived for 10 years after receiving radiation treatment between 1970 and 1986. The rates of cardiovascular disease in these women were compared with those seen in the general population.
A total of 942 cardiovascular events were logged during a median follow-up period of 18 years.
According to the results, radiation that was limited to the breast did not increase the risk of cardiovascular disease. Inclusion of the surrounding breast tissue, however, did increase the risk.
Radiation to the breast and surrounding tissue performed in the 1970s appeared to increase the risk of heart attack and heart failure by 2.55- and 1.72-fold, respectively, compared with no radiation.
By contrast, radiotherapy in the 1980s did not raise the risk of heart attack, but was associated with 2.66- and 3.17-fold increased risks of heart failure and heart valve dysfunction, respectively.
In the 1980s, adding chemotherapy to radiotherapy increased the risk of congestive heart failure by 1.85-fold. Moreover, a 3-fold increased risk of heart attack was seen in radiotherapy-treated patients who also smoked.
In a related editorial, Dr. Sharon H. Giordano and Dr. Gabriel N. Hortobagyi, from the M.D. Anderson Cancer Center in Houston, comment that the study "provides important new information on the cardiac toxicity of radiation therapy."
They also praise the study's methodology, calling the 18-year follow-up period "impressively long" and citing certain unique features, including evaluation of both morbidity and mortality, and comparison of toxicity by radiation fields.
SOURCE: Journal of the National Cancer Institute, March 7, 2007.
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