Cardiac morbidity of adjuvant radiotherapy for breast cancer

Debra A. Patt, James Goodwin, Yong Fang Kuo, Jean L. Freeman, Dong Zhang, Thomas A. Buchholz, Gabriel N. Hortobagyi, Sharon H. Giordano

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

Purpose: Adjuvant breast irradiation has been associated with an increase in cardiac mortality, because left-sided breast radiation can produce cardiac damage. The purpose of this study was to determine whether modern adjuvant radiotherapy is associated with increased risk of cardiac morbidity. Patients and Methods: Data from the Surveillance, Epidemiology, and End Results-Medicare database were used for women who were diagnosed with nonmetastatic breast cancer from 1986 to 1993, had known disease laterality, underwent breast surgery, and received adjuvant radiotherapy. The Cox proportional-hazards model was used to compare patients with left- versus right-sided breast cancer for the end points of hospitalization with the following discharge diagnoses (International Classification of Diseases, 9th Revision codes): ischemic heart disease (410-414, 36.0, and 36.1), valvular heart disease (394-397, 424, 35), congestive heart failure (428, 402.01, 402.11, 402.91, and 425), and conduction abnormalities (426, 427, 37.7-37.8, and 37.94-37.99). Results: Eight thousand three hundred sixty-three patients had left-sided breast cancer, and 7,907 had right-sided breast cancer. Mean follow-up was 9.5 years (range, 0 to 15 years). There were no significant differences in patients with left- versus right-sided cancers for hospitalization for ischemic heart disease (9.9% v 9.7%), valvular heart disease (2.9% v 2.8%), conduction abnormalities (9.7% v 9.6%), or heart failure (9.7% v 9.7%). The adjusted hazard ratio for left- versus right-sided breast cancer was 1.05 (95% CI, 0.94 to 1.16) for ischemic heart disease, 1.07 (95% CI, 0.89 to 1.30) for valvular heart disease, 1.07 (95% CI, 0.96 to 1.19) for conduction abnormalities, and 1.05 (95% CI, 0.95 to 1.17) for heart failure. Conclusion: With up to 15 years of follow-up there were no significant differences in cardiac morbidity after radiation for left- versus right-sided breast cancer.

Original languageEnglish (US)
Pages (from-to)7475-7482
Number of pages8
JournalJournal of Clinical Oncology
Volume23
Issue number30
DOIs
StatePublished - 2005

Fingerprint

Adjuvant Radiotherapy
Heart Valve Diseases
Breast Neoplasms
Morbidity
Myocardial Ischemia
Breast
Heart Failure
Hospitalization
Radiation
International Classification of Diseases
Medicare
Proportional Hazards Models
Epidemiology
Unilateral Breast Neoplasms
Databases
Mortality
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Patt, D. A., Goodwin, J., Kuo, Y. F., Freeman, J. L., Zhang, D., Buchholz, T. A., ... Giordano, S. H. (2005). Cardiac morbidity of adjuvant radiotherapy for breast cancer. Journal of Clinical Oncology, 23(30), 7475-7482. https://doi.org/10.1200/JCO.2005.13.755

Cardiac morbidity of adjuvant radiotherapy for breast cancer. / Patt, Debra A.; Goodwin, James; Kuo, Yong Fang; Freeman, Jean L.; Zhang, Dong; Buchholz, Thomas A.; Hortobagyi, Gabriel N.; Giordano, Sharon H.

In: Journal of Clinical Oncology, Vol. 23, No. 30, 2005, p. 7475-7482.

Research output: Contribution to journalArticle

Patt, DA, Goodwin, J, Kuo, YF, Freeman, JL, Zhang, D, Buchholz, TA, Hortobagyi, GN & Giordano, SH 2005, 'Cardiac morbidity of adjuvant radiotherapy for breast cancer', Journal of Clinical Oncology, vol. 23, no. 30, pp. 7475-7482. https://doi.org/10.1200/JCO.2005.13.755
Patt, Debra A. ; Goodwin, James ; Kuo, Yong Fang ; Freeman, Jean L. ; Zhang, Dong ; Buchholz, Thomas A. ; Hortobagyi, Gabriel N. ; Giordano, Sharon H. / Cardiac morbidity of adjuvant radiotherapy for breast cancer. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 30. pp. 7475-7482.
@article{647b03eb785d447d93230a93e35b30d3,
title = "Cardiac morbidity of adjuvant radiotherapy for breast cancer",
abstract = "Purpose: Adjuvant breast irradiation has been associated with an increase in cardiac mortality, because left-sided breast radiation can produce cardiac damage. The purpose of this study was to determine whether modern adjuvant radiotherapy is associated with increased risk of cardiac morbidity. Patients and Methods: Data from the Surveillance, Epidemiology, and End Results-Medicare database were used for women who were diagnosed with nonmetastatic breast cancer from 1986 to 1993, had known disease laterality, underwent breast surgery, and received adjuvant radiotherapy. The Cox proportional-hazards model was used to compare patients with left- versus right-sided breast cancer for the end points of hospitalization with the following discharge diagnoses (International Classification of Diseases, 9th Revision codes): ischemic heart disease (410-414, 36.0, and 36.1), valvular heart disease (394-397, 424, 35), congestive heart failure (428, 402.01, 402.11, 402.91, and 425), and conduction abnormalities (426, 427, 37.7-37.8, and 37.94-37.99). Results: Eight thousand three hundred sixty-three patients had left-sided breast cancer, and 7,907 had right-sided breast cancer. Mean follow-up was 9.5 years (range, 0 to 15 years). There were no significant differences in patients with left- versus right-sided cancers for hospitalization for ischemic heart disease (9.9{\%} v 9.7{\%}), valvular heart disease (2.9{\%} v 2.8{\%}), conduction abnormalities (9.7{\%} v 9.6{\%}), or heart failure (9.7{\%} v 9.7{\%}). The adjusted hazard ratio for left- versus right-sided breast cancer was 1.05 (95{\%} CI, 0.94 to 1.16) for ischemic heart disease, 1.07 (95{\%} CI, 0.89 to 1.30) for valvular heart disease, 1.07 (95{\%} CI, 0.96 to 1.19) for conduction abnormalities, and 1.05 (95{\%} CI, 0.95 to 1.17) for heart failure. Conclusion: With up to 15 years of follow-up there were no significant differences in cardiac morbidity after radiation for left- versus right-sided breast cancer.",
author = "Patt, {Debra A.} and James Goodwin and Kuo, {Yong Fang} and Freeman, {Jean L.} and Dong Zhang and Buchholz, {Thomas A.} and Hortobagyi, {Gabriel N.} and Giordano, {Sharon H.}",
year = "2005",
doi = "10.1200/JCO.2005.13.755",
language = "English (US)",
volume = "23",
pages = "7475--7482",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "30",

}

TY - JOUR

T1 - Cardiac morbidity of adjuvant radiotherapy for breast cancer

AU - Patt, Debra A.

AU - Goodwin, James

AU - Kuo, Yong Fang

AU - Freeman, Jean L.

AU - Zhang, Dong

AU - Buchholz, Thomas A.

AU - Hortobagyi, Gabriel N.

AU - Giordano, Sharon H.

PY - 2005

Y1 - 2005

N2 - Purpose: Adjuvant breast irradiation has been associated with an increase in cardiac mortality, because left-sided breast radiation can produce cardiac damage. The purpose of this study was to determine whether modern adjuvant radiotherapy is associated with increased risk of cardiac morbidity. Patients and Methods: Data from the Surveillance, Epidemiology, and End Results-Medicare database were used for women who were diagnosed with nonmetastatic breast cancer from 1986 to 1993, had known disease laterality, underwent breast surgery, and received adjuvant radiotherapy. The Cox proportional-hazards model was used to compare patients with left- versus right-sided breast cancer for the end points of hospitalization with the following discharge diagnoses (International Classification of Diseases, 9th Revision codes): ischemic heart disease (410-414, 36.0, and 36.1), valvular heart disease (394-397, 424, 35), congestive heart failure (428, 402.01, 402.11, 402.91, and 425), and conduction abnormalities (426, 427, 37.7-37.8, and 37.94-37.99). Results: Eight thousand three hundred sixty-three patients had left-sided breast cancer, and 7,907 had right-sided breast cancer. Mean follow-up was 9.5 years (range, 0 to 15 years). There were no significant differences in patients with left- versus right-sided cancers for hospitalization for ischemic heart disease (9.9% v 9.7%), valvular heart disease (2.9% v 2.8%), conduction abnormalities (9.7% v 9.6%), or heart failure (9.7% v 9.7%). The adjusted hazard ratio for left- versus right-sided breast cancer was 1.05 (95% CI, 0.94 to 1.16) for ischemic heart disease, 1.07 (95% CI, 0.89 to 1.30) for valvular heart disease, 1.07 (95% CI, 0.96 to 1.19) for conduction abnormalities, and 1.05 (95% CI, 0.95 to 1.17) for heart failure. Conclusion: With up to 15 years of follow-up there were no significant differences in cardiac morbidity after radiation for left- versus right-sided breast cancer.

AB - Purpose: Adjuvant breast irradiation has been associated with an increase in cardiac mortality, because left-sided breast radiation can produce cardiac damage. The purpose of this study was to determine whether modern adjuvant radiotherapy is associated with increased risk of cardiac morbidity. Patients and Methods: Data from the Surveillance, Epidemiology, and End Results-Medicare database were used for women who were diagnosed with nonmetastatic breast cancer from 1986 to 1993, had known disease laterality, underwent breast surgery, and received adjuvant radiotherapy. The Cox proportional-hazards model was used to compare patients with left- versus right-sided breast cancer for the end points of hospitalization with the following discharge diagnoses (International Classification of Diseases, 9th Revision codes): ischemic heart disease (410-414, 36.0, and 36.1), valvular heart disease (394-397, 424, 35), congestive heart failure (428, 402.01, 402.11, 402.91, and 425), and conduction abnormalities (426, 427, 37.7-37.8, and 37.94-37.99). Results: Eight thousand three hundred sixty-three patients had left-sided breast cancer, and 7,907 had right-sided breast cancer. Mean follow-up was 9.5 years (range, 0 to 15 years). There were no significant differences in patients with left- versus right-sided cancers for hospitalization for ischemic heart disease (9.9% v 9.7%), valvular heart disease (2.9% v 2.8%), conduction abnormalities (9.7% v 9.6%), or heart failure (9.7% v 9.7%). The adjusted hazard ratio for left- versus right-sided breast cancer was 1.05 (95% CI, 0.94 to 1.16) for ischemic heart disease, 1.07 (95% CI, 0.89 to 1.30) for valvular heart disease, 1.07 (95% CI, 0.96 to 1.19) for conduction abnormalities, and 1.05 (95% CI, 0.95 to 1.17) for heart failure. Conclusion: With up to 15 years of follow-up there were no significant differences in cardiac morbidity after radiation for left- versus right-sided breast cancer.

UR - http://www.scopus.com/inward/record.url?scp=32944462609&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=32944462609&partnerID=8YFLogxK

U2 - 10.1200/JCO.2005.13.755

DO - 10.1200/JCO.2005.13.755

M3 - Article

VL - 23

SP - 7475

EP - 7482

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 30

ER -