Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ

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Wadsten , C , Wennstig , A -K , Garmo , H , Nilsson , G , Blomqvist , C , Holmberg , L , Fredriksson , I , Wärnberg , F & Sund , M 2018 , ' Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ ' , Breast Cancer Research and Treatment , vol. 171 , no. 1 , pp. 95-101 . https://doi.org/10.1007/s10549-018-4803-1

Title: Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ
Author: Wadsten, C.; Wennstig, A. -K.; Garmo, H.; Nilsson, Greger; Blomqvist, Carl; Holmberg, Lars; Fredriksson, Irma; Wärnberg, F.; Sund, M.
Contributor organization: Department of Oncology
HUS Comprehensive Cancer Center
Date: 2018-08
Language: eng
Number of pages: 7
Belongs to series: Breast Cancer Research and Treatment
ISSN: 0167-6806
DOI: https://doi.org/10.1007/s10549-018-4803-1
URI: http://hdl.handle.net/10138/237855
Abstract: The use of adjuvant radiotherapy (RT) in the management of ductal carcinoma in situ (DCIS) is increasing. Left-sided breast irradiation may involve exposure of the heart to ionising radiation, increasing the risk of ischemic heart disease (IHD). We examined the incidence of IHD in a population-based cohort of women with DCIS. The Breast Cancer DataBase Sweden (BCBase) cohort includes women registered with invasive and in situ breast cancers 1992-2012 and age-matched women without a history of breast cancer. In this analysis, 6270 women with DCIS and a comparison cohort of 31,257 women were included. Through linkage with population-based registers, data on comorbidity, socioeconomic status and incidence of IHD was obtained. Hazard ratios (HR) for IHD with 95% confidence intervals (CI) were analysed. Median follow-up time was 8.8 years. The risk of IHD was not increased for women with DCIS versus women in the comparison cohort (HR 0.93; 95% CI 0.82-1.06), after treatment with radiotherapy versus surgery alone (HR 0.77; 95% CI 0.60-0.98) or when analysing RT by laterality (HR 0.85; 95% CI 0.53-1.37 for left-sided versus right-sided RT). The risk of IHD was lower for women with DCIS allocated to RT compared to non-irradiated women and to the comparison cohort, probably due to patient selection. Comparison of RT by laterality did not show any over-risk for irradiation of the left breast.
Subject: Ductal carcinoma in situ
Ischemic heart disease
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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