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Breast Cancer & Heart Health: New Information on the Impact of Radiation

Breast Cancer & Heart Health: New Information on the Impact of Radiation

For many women with breast cancer, radiation is an integral part of their treatment plans.   

But many research studies have shown an increase of heart disease due to incidental irradiation of the heart. The effect shown has been more pronounced in breast cancers of the left breast, although right-sided breast cancers that require radiation to surrounding lymph nodes may also have increased radiation exposure to the heart. 

A landmark study that was published in the New England Journal of Medicine in 2013 showed a clear linear relationship between radiation dose to the heart and the risk of developing heart disease. These results were reproduced and confirmed by another key study published in 2017 (van den Bogaard et al.) in the Journal of Clinical Oncology in which patients were treated with modern radiation techniques and thus applicable to the patients of today.

Given this information, the lower the radiation exposure to the heart, the lower the risk of developing heart disease. There are several techniques used by radiation oncologists to decrease the dose to the heart. Proton therapy is one such modality that can often significantly reduce heart dose by having a unique characteristic that allows us to control where the radiation beam stops. The SCCA proton center currently has open a clinical study aimed to determine whether proton therapy leads to lower risk of long-term side effects. Most patients that have involvement of the lymph nodes will be eligible for this study.  

What can breast cancer patients do to advocate for themselves and their health?

First, review your radiation plan with your physician. Given your case and health history, what is the lowest possible therapeutic radiation dose?

Secondly, investigate targeted radiation modalities such as proton therapy. Radiation technologies that stop at the tumor and spare nearby organs from excess radiation can reduce the overall impact to the heart. 

And finally, ask your doctor to evaluate your risk of radiation-related heart disease, and weigh it against the risk of recurrence or death from breast cancer that would be achieved with radiotherapy. This will help you make the best decision for your long-term health.

Knowledge is power; this study will help breast cancer patients evaluate risks and choose their treatment plans.