ArticleBreast cancer research and treatment2022
Cardiac late effects after modern 3D-conformal radiotherapy in breast cancer patients: a retrospective cohort study in Germany (ESCaRa).
Article in Breast cancer research and treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Trial
- Long-Term Risk of Cardiovascular Disease After Contemporary Left-Sided Breast Radiation Therapy.JAMA network open · 2026Article
- Risk of cardiovascular-related death after radiotherapy for thoracic cancer.Radiation oncology (London, England) · 2025Article
- Consequences of ionizing radiation exposure to the cardiovascular system.Nature reviews. Cardiology · 2024Review
- Impact of deep inspiration breath hold, surface-guided radiotherapy, and daily CBCT on the organs at risk in breast cancer radiotherapy.Scientific reports · 2024Article
- Accelerated Atherosclerosis and Cardiovascular Toxicity Induced by Radiotherapy in Breast Cancer.Life (Basel, Switzerland) · 2023Review
- Particle radiotherapy for breast cancer.Frontiers in oncology · 2023Review
- A nested case-control study on radiation dose-response for cardiac events in breast cancer patients in Germany.Breast (Edinburgh, Scotland) · 2022Article
- Accelerated hypofractionated breast radiotherapy with simultaneous integrated boost: a feasibility study.Radiation oncology journal · 2022Article
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
purposeRadiotherapy (RT) was identified as a risk factor for long-term cardiac effects in breast cancer patients treated until the 1990s. However, modern techniques reduce radiation exposure of the heart, but some exposure remains unavoidable. In a retrospective cohort study, we investigated cardiac mortality and morbidity of breast cancer survivors treated with recent RT in Germany.
methodsA total of 11,982 breast cancer patients treated between 1998 and 2008 were included. A mortality follow-up was conducted until 06/2018. In order to assess cardiac morbidity occurring after breast cancer treatment, a questionnaire was sent out in 2014 and 2019. The effect of breast cancer laterality on cardiac mortality and morbidity was investigated as a proxy for radiation exposure. We used Cox Proportional Hazards regression analysis, taking potential confounders into account.
resultsAfter a median follow-up time of 11.1 years, there was no significant association of tumor laterality with cardiac mortality in irradiated patients (hazard ratio (HR) for left-sided versus right-sided tumor 1.09; 95% confidence interval (CI) 0.85-1.41). Furthermore, tumor laterality was not identified as a significant risk factor for cardiac morbidity (HR = 1.05; 95%CI 0.88-1.25).
conclusionsEven though RT for left-sided breast cancer on average incurs higher radiation dose to the heart than RT for right-sided tumors, we found no evidence that laterality is a strong risk factor for cardiac disease after contemporary RT. However, larger sample sizes, longer follow-up, detailed information on individual risk factors and heart dose are needed to assess clinically manifest late effects of current cancer therapy.
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