ArticleFrontiers in cardiovascular medicine2026
Association between radiotherapy laterality and cardiovascular disease mortality in male breast cancer patients receiving postoperative radiotherapy: a competing risks analysis and standardized mortality ratio assessment using SEER data.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The association between radiotherapy (RT) laterality and cardiovascular disease (CVD) mortality in male breast cancer (MBC) remains unknown. We evaluated whether left-sided RT confers higher CVD mortality than right-sided RT in MBC patients, and quantified excess CVD mortality relative to the general U.S. male population. Methods: This retrospective cohort study included 2,152 MBC patients receiving postoperative RT from the SEER database (2000-2020). Fine-Gray competing risks regression estimated subdistribution hazard ratios (sHRs) for CVD death comparing left- vs. right-sided RT. Multiple sensitivity analyses were performed, including propensity score matching (PSM). Standardized mortality ratios (SMRs) were calculated using age-specific CVD mortality rates from CDC WONDER. Results: Over a median follow-up of 5.6 years, no significant difference in CVD mortality was observed between left- and right-sided RT (fully adjusted sHR = 1.03; 95% CI: 0.71-1.49; Conclusions: In MBC patients receiving modern RT, left- and right-sided treatment confer comparable risks of CVD mortality. Nevertheless, overall CVD mortality remains significantly higher than in the general U.S. male population, warranting comprehensive cardiovascular risk assessment and management for all RT recipients.
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