ArticleCancer medicine2021
Cardiotoxicity screening of long-term, breast cancer survivors-The CAROLE (Cardiac-Related Oncologic Late Effects) Study.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Long-term risk of heart failure in adult cancer survivors: a systematic review and meta-analysis.Heart (British Cardiac Society) · 2024Pooled it
- Genetic risk stratification of common diseases in breast cancer survivors: a population-based cohort study.JNCI cancer spectrum · 2026Article
- Heart Substructure Radiation Dose and Cardiac Outcomes: Contemporary Evidence and Actionable Opportunities: JACC CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2026Review
- The evolution of cardiac changes after breast cancer adjuvant radiotherapy - A six-year follow-up study.Clinical and translational radiation oncology · 2026Article
- Imaging-based detection and prediction of radiation-induced cardiac toxicity: a narrative review.BJR open · 2026Review
- Development of a model to guide the decision for radiotherapy in deep-inspiration breath-hold in patients with left-sided breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Polygenic risk of coronary artery disease for long-term survivors of breast cancer.Journal of the National Cancer Institute · 2025Article
- Review
- Utility of global longitudinal strain in early identification of chronic cardiotoxicity in asymptomatic long-term malignant lymphoma survivors with normal left ventricle ejection fraction.Scientific reports · 2025Article
- Simplified rules-based tool to facilitate the application of up-to-date management recommendations in cardio-oncology.Cardio-oncology (London, England) · 2023Article
- Cardiovascular disease/stroke risk stratification in deep learning framework: a review.Cardiovascular diagnosis and therapy · 2023Review
- Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension-Mechanisms and Mitigation.Hypertension (Dallas, Tex. : 1979) · 2023Review
- Screening for Coronary Artery Disease in Cancer Survivors:JACC. CardioOncology · 2023Review
- Long-Term Effects of Breast Cancer Therapy and Care: Calm after the Storm?Journal of clinical medicine · 2022Review
- Radiation-Induced Cardiovascular Toxicities.Current treatment options in oncology · 2022Review
- Radiation-Induced Cardiac Dysfunction: Optimizing Radiation Delivery and Postradiation Care.Heart failure clinics · 2022Review
- Next Generation Risk Markers in Preventive Cardio-oncology.Current atherosclerosis reports · 2022Review
- Cardiotoxicity screening of long-term, breast cancer survivors-The CAROLE (Cardiac-Related Oncologic Late Effects) Study.Cancer medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundLong-term breast cancer survivors are at risk for cardiotoxicity after treatment, but there is insufficient evidence to provide long-term (~10 years) cardiovascular disease (CVD) screening recommendations. We sought to evaluate a tri-modality CVD screening approach.
methodsThis single-arm, feasibility study enrolled 201 breast cancer patients treated ≥6 years prior without CVD at diagnosis. Patients were sub-grouped: cardiotoxic (left-sided) radiation (RT), cardiotoxic (anthracycline-based) chemotherapy, both cardiotoxic chemotherapy and RT, and neither cardiotoxic treatment. Patients underwent electrocardiogram (EKG), transthoracic echocardiogram with strain (TTE with GLS), and coronary artery calcium computed tomography (CAC CT). The primary endpoint was preclinical or clinical CVD.
resultsMedian age was 50 (29-65) at diagnosis and 63 (37-77) at imaging; median interval was 11.5 years (6.7-14.5). Among sub-groups, 44% had no cardiotoxic treatment, 31.5% had cardiotoxic RT, 16% had cardiotoxic chemotherapy, and 8.5% had both. Overall, 77.6% showed preclinical and/or clinical CVD and 51.5% showed clinical CVD. Per modality, rates of any CVD and clinical CVD were, respectively: 27.1%/10.0% on EKG, 50.0%/25.3% on TTE with GLS, and 50.8%/45.8% on CAC CT. No statistical difference was seen among the treatment subgroups (NS, χ
conclusionThis study identified a high incidence of CVD in heterogenous long-term breast cancer survivors, most >10 years post-treatment. Over half had clinical CVD findings warranting follow-up and/or intervention. Each imaging test independently contributed to the detection rate. This provides early evidence that long-term cardiac screening may be of value to a wider group of breast cancer survivors than previously recognized.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.