Document Detail

Distribution of coronary artery stenosis after radiation for breast cancer.
MedLine Citation:
PMID:  22203772     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To study distribution of coronary artery stenosis among patients with breast cancer (BC) and to assess correlation between radiotherapy (RT) and location of stenosis.
PATIENTS AND METHODS: A Swedish BC cohort diagnosed from 1970 to 2003 was linked to registers of coronary angiography from 1990 to 2004, which yielded 199 patients. Stenoses of the coronary arteries were graded from 0 to 5, where 0 indicated a normal vessel and 5 indicated occlusion. Two hotspot areas for radiation were defined: proximal right coronary artery (prox RCA), mid and distal left anterior descending artery and distal diagonal (mdLAD + dD). RT regimens were categorized as high or low risk of irradiating the hotspot areas. Left breast/chest wall was considered high risk for mdLAD + dD; left internal mammary chain (IMC), high risk for prox RCA and mdLAD + dD from 1970 to 1995 and thereafter solely for mdLAD + dD; and right IMC, high risk for prox RCA. Other RT targets and no RT were considered low risk. Results were expressed in odds ratios (ORs) and 95% CIs.
RESULTS: For irradiated left- versus right-sided BC, the OR for grade 3 to 5 stenosis in mdLAD + dD was 4.38 (95% CI, 1.64 to 11.7), and for grade 4 to 5 stenosis, the OR was 7.22 (95% CI, 1.64 to 31.8). For high-risk RT versus low-risk or no RT, the OR for grade 3 to 5 stenosis in hotspot areas was 1.90 (95% CI, 1.11 to 3.24).
CONCLUSION: An increase of stenosis in mdLAD + dD in irradiated left-sided BC and an association between high-risk RT and stenosis in hotspot areas for radiation indicate a direct link between radiation and location of coronary stenoses.
Greger Nilsson; Lars Holmberg; Hans Garmo; Olov Duvernoy; Iwar Sjögren; Bo Lagerqvist; Carl Blomqvist
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-12-27
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  30     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-03     Completed Date:  2012-05-08     Revised Date:  2012-12-18    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  380-6     Citation Subset:  IM    
Uppsala University, University Hospital, SE-751 85 Uppsala, Sweden.
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MeSH Terms
Aged, 80 and over
Breast Neoplasms / epidemiology*,  radiotherapy*
Cohort Studies
Coronary Angiography / methods
Coronary Stenosis / epidemiology*,  etiology
Middle Aged
Radiation Injuries / epidemiology*,  etiology
Radiotherapy / adverse effects,  statistics & numerical data
Randomized Controlled Trials as Topic
Sweden / epidemiology
Grant Support
//Cancer Research UK
Comment In:
Strahlenther Onkol. 2012 Nov;188(11):1054-6   [PMID:  23053154 ]
J Clin Oncol. 2012 Feb 1;30(4):350-2   [PMID:  22203762 ]

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