Breast Radiation Causes Heart Disease – For Very, Very Few

Breast Radiation Causes Heart Disease – For Very, Very Few

Breast radiation remains necessary for women with early stage breast cancer if they wish to avoid mastectomy. Like all cancer treatments, there are potential side-effects–most of which are minor. A small minority of patients receiving such treatment may be at higher risk for heart disease.

Overall, the risk of heart disease for most patients is very low since radiation treatments are designed to completely (or mostly) avoid the heart. But a report from the New England Journal of Medicine showed an undeniable increase in the risk of heart disease in 2,168 patients receiving breast radiation. How high was the risk? About half a percent for those receiving the highest radiation dose to the heart.  Estimating the total dose given to the heart is one of the problems with the NEJM study. The other? The cases dated from 1958 to 2001, and included a large number of patients treated without modern targeting techniques such as multidimensional targeting and breath hold.

It’s estimated that contemporary radiation techniques deliver less than 2 Gy of radiation (a very small amount)  to the heart -which is far less than that given to most of women in the NEJM study treated before the 1980s.

What’s the bottom line? If the risk of recurrence is significant, the benefits of radiation still heavily outweigh the potential risk of heart disease, especially given modern radiation techniques.

Read more about it here:

http://www.ascopost.com/issues/october-15,-2013/breast-cancer-radiotherapy-and-cardiotoxicity-what-is-the-true-risk.aspx

http://www.ncbi.nlm.nih.gov/pubmed/?term=N+Engl+J+Med+368%3A987-998%2C+2013