ArticleInternational journal of cancer2020
Cardiac mortality after radiotherapy, chemotherapy and endocrine therapy for breast cancer: Cohort study of 2 million women from 57 cancer registries in 22 countries.
Article in International journal of cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Attributable fraction of cardiac disease following radiotherapy among breast cancer survivors: a systematic review and meta-analysis.Journal of radiation research · 2026Pooled it
- European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment.European heart journal. Quality of care & clinical outcomes · 2022Guideline
- Ultra-Hypofractionated vs. Moderate Fractionated Whole Breast Three Dimensional Conformal Radiotherapy during the COVID-19 Pandemic.Medicina (Kaunas, Lithuania) · 2022Trial
- A clinical trial to compare a 3D-printed bolus with a conventional bolus with the aim of reducing cardiopulmonary exposure in postmastectomy patients with volumetric modulated arc therapy.Cancer medicine · 2022Trial
- Advancing Particle Therapy to Improve Cancer Care: Report on "2nd World Forum on Particle Therapy".International journal of particle therapy · 2026Review
- Risk of myocardial infarction and stroke after breast cancer: an analysis of a population of 1.3 million women from North-West Italy.Breast cancer research and treatment · 2026Article
- Cardiovascular disease risk following radiotherapy among breast cancer survivors: a nationwide cohort study in South Korea.Breast cancer research : BCR · 2025Article
- Cardiac Substructure Dose Reduction and Toxicity Risk Assessment: IMPT Versus IMRT for Breast Cancer.International journal of particle therapy · 2025Article
- Artificial Intelligence-Driven Strategies for Targeted Delivery and Enhanced Stability of RNA-Based Lipid Nanoparticle Cancer Vaccines.Pharmaceutics · 2025Review
- Improvement of plan quality in whole-breast radiation following BCS using feasibility DVH by less-experienced planners.Physical and engineering sciences in medicine · 2025Article
- Advances in cardiac ultrasound speckle tracking technology for assessing left ventricular systolic function after adjuvant radiotherapy following breast-conserving surgery for breast cancer.American journal of translational research · 2025Review
- Multi-omics analysis reveals the unique landscape of DLD in the breast cancer tumor microenvironment and its implications for immune-related prognosis.Computational and structural biotechnology journal · 2024Article
- Surface-based deep inspiration breath-hold radiotherapy in left-sided breast cancer: final results from the SAVE-HEART study.ESMO open · 2024Article
- Evaluation of Tumor Control and Normal Tissue Complication Probabilities in Patients Receiving Comprehensive Nodal Irradiation for Left-Sided Breast Cancer.Current oncology (Toronto, Ont.) · 2024Article
- Comparative dosimetric and radiobiological assessment of left-sided whole breast and regional nodes with advanced radiotherapy techniques.Journal of radiation research · 2023Article
- Current Cardioprotective Strategies for the Prevention of Radiation-Induced Cardiotoxicity in Left-Sided Breast Cancer Patients.Journal of personalized medicine · 2023Review
- Ten-Year Probabilities of Death Due to Cancer and Cardiovascular Disease among Breast Cancer Patients Diagnosed in North-Eastern Spain.International journal of environmental research and public health · 2022Article
- Novel lipometabolism biomarker for chemotherapy and immunotherapy response in breast cancer.BMC cancer · 2022Article
- Article
- Association Between Radiotherapy and Death From Cardiovascular Disease Among Patients With Cancer: A Large Population-Based Cohort Study.Journal of the American Heart Association · 2022Article
Corrections and comments
- Erratum issuedErratum.2021
Authors and funding
6 authors.
Funding
Abstract
Comparisons of patients receiving different cancer treatments reflect the effects of both treatment and patient selection. In breast cancer, however, if radiotherapy decisions are unrelated to laterality, comparisons of left-sided and right-sided cancers can demonstrate the causal effects of higher-versus-lower cardiac radiation dose. Cardiac mortality was analysed using individual patient data for 1,934,248 women with breast cancer in 22 countries. The median date of diagnosis was 1996 and the interquartile range was 1987-2002. A total of 1,018,505 women were recorded as irradiated, 223,077 as receiving chemotherapy, 317,619 as receiving endocrine therapy and 55,264 died of cardiac disease. Analyses were stratified by time since breast cancer diagnosis, age at diagnosis, calendar year of diagnosis and country. Patient-selection effects were evident for all three treatments. For radiotherapy, there was also evidence of selection according to laterality in women irradiated 1990 or later. In patients irradiated before 1990, there was no such selection and cardiac mortality was higher in left-sided than right-sided cancer (rate ratio [RR]: 1.13, 95% confidence interval 1.09-1.17). Left-versus-right cardiac mortality RRs were greater among younger women (1.46, 1.19, 1.20, 1.09 and 1.08 after cancer diagnoses at ages <40, 40-49, 50-59, 60-69 and 70+ years, 2p
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