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Heart risk after breast cancer therapy

Wednesday August 1st, 2018

Long term breast cancer survivors may face significantly increased cardiovascular disease risks because of the treatments they underwent, Dutch researchers report today.

The team was led by Dr Naomi Boekel, of Netherlands Cancer Institute, Amsterdam, The Netherlands. They carried out a large, population-based study on cardiovascular disease in 14,645 breast cancer survivors treated in the 1970s or later.

While radiotherapy and anthracycline-based chemotherapy are highly effective against breast cancer, these therapies have also been linked to negative effects on the heart.

Dr Boekel and colleagues examined the separate and combined effects of various treatments.

In today's (1 August) British Journal of Cancer they write that irradiation of the lymph nodes behind the sternum (known as IMC-irradiation) given between 1970 and 2009 exposed the heart to high heart doses of radiation.

Analysis of follow-up information showed that IMC-irradiation is linked with a doubling in the risk of different cardiovascular diseases, compared to the risk for patients who received the lowest cardiac doses.

They write: "In patients with an established cardiovascular risk factor, 20-year cumulative incidence of ischaemic heart disease is 11% in patients with IMC-irradiation versus 6% in those without."

They also found that anthracycline drugs are linked to a four-fold increased risk of heart failure, reaching a nine-fold increased risk when combined with IMC-irradiation.

Fortunately, the experts add: "Current radiation techniques expose the heart to lower doses, and radiation-associated cardiovascular disease risks are hence expected to be lower in patients treated today."

Boekel, N, B. et al. British Journal of Cancer 1 August 2018 doi: s41416-018-0159-x

https://www.nature.com/articles/s41416-018-0159-x

Tags: Cancer | Europe | Heart Health | Pharmaceuticals | Women's Health & Gynaecology

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