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 troublesome and scary as the cancer.
This report is an important follow-up to an earlier Research News story on radiation and heart disease risk. The study reviewed here is very good news and underscores the breastcancer.org message in the earlier story.
Today, advances in technology make the heart and surrounding breast tissue much less likely to be exposed to radiation. In the study reviewed here, women with breast cancer who got radiation therapy with more advanced, safer techniques developed during the 1980s and 1990s had a lower risk of heart problems compared to women without breast cancer.
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. In addition, other new technologies give 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 only for the breast area. Some newer radiation therapy equipment actually tracks heart beats and the movement of your lungs and effectively blocks those tissues from any radiation exposure. Researchers are working to develop even better, safer approaches to radiation therapy.
The take-home message from the earlier Research News story is worth repeating here. 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) - Modern radiation therapy for early breast cancer seems to be much less toxic to the heart than older radiation regimens, according to a University of Michigan-Ann Arbor study.
A "critical component" of therapy, radiation therapy reduces the risk of breast cancer recurrence and improves survival after breast-conserving surgery in women with early breast cancer, the study team notes in the journal Cancer.
"However, older techniques of radiation therapy resulted in substantial radiation doses to the heart, particularly in patients with left-sided breast cancer," UM oncologist and first author Dr. Reshma Jagsi told Reuters Health. These regimens were found to raise the risk of heart disease. But the impact on the heart of more modern radiation regimens is less well known.
"We wished to examine whether women treated with radiation after breast-conserving surgery for early-stage breast cancer at our institution in the 1980s and 1990s had an increased risk of coronary artery disease," Jagsi said.
The team found, based on the records of more than 800 women, that the rates of heart attack and heart disease that required treatment were very low; in fact, the rates were significantly lower than the rates that would normally be expected in women without breast cancer.
"We did find a slight increase in the risk of heart attacks in patients treated to the left side of the chest compared to those treated to the right side," Jagsi said. "However, the absolute risk was extremely low."
Twelve women (1.4 percent) suffered at least one heart attack and 20 (2.4 percent) had at least one heart attack or episode of coronary artery disease requiring treatment after an average follow-up time of 6.8 years.
The 10-year rate of heart attack was 1.2 percent and the rate of heart attack or heart disease requiring treatment was 2.7 percent. The average interval from radiation treatment to a heart disease event was 3.7 years. Heart attacks and other cardiac-related events after radiation therapy occurred most often in older smokers with diabetes.
Despite the very low risk, "our study provides evidence to support the exploration of more sophisticated techniques of radiation treatment that reduce the radiation dose received by the heart," Jagsi told Reuters Health.
"Our findings," the researcher emphasized, "do not in any way suggest that patients treated with breast-conserving therapy should consider omitting radiation, as radiation is critical for reducing the much more substantial risks of recurrence and death from breast cancer in these patients."
SOURCE: Cancer 2007.
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