Anant Madabhushi: Radiation Therapy in Breast Cancer and Coronary Artery Diseases risk
“Thrilled to be part of new publication “Laterality of Radiation Therapy in Breast Cancer is Not Associated with Increased Risk for Coronary Artery Disease in the Contemporary Era” just published in the journal Advances in Radiation Oncology.
Work led by Dr Avirup Guha, MD, MPH, RPVI, FICOS, FACC, FAHA from Medical College of Georgia at Augusta University.
External beam radiation therapy (EBRT) is a critical component of breast cancer (BC) therapy. Given the improvement in technology in the contemporary era, we hypothesize there is no difference the development of or worsening of existing coronary artery disease (CAD) in patients with BC receiving left vs right sided radiation.
For the meta-analysis portion of our study, we searched PubMed, Web of Science, and Scopus and included studies from January 1999 to September 2022. CAD was identified using a homogenous metric across multiple studies included. We computed the risk ratio (RR) for included studies using a random effects model.
For the institutional cohort portion of our study, we selected high cardiovascular risk patients diagnosed with BC between 2010-2022 if they met our inclusion criteria. We performed a Cox proportional hazards model with stepwise adjustment.
A pooled random effects model with 9 studies showed that patients with left-sided BC receiving EBRT had a 10% increased risk of CAD when compared to patients with right-sided BC receiving EBRT (RR: 1.10, 95% CI: 1.02 – 1.18, p = 0.01). However, subgroup analysis of 6 studies that included patients diagnosed after 1980 did not show a significant difference in CAD based on BC laterality (RR: 1.07, 95% CI: 0.95 – 1.20, p = 0.27). For the institutional cohort portion of the study, we found that patients with left-sided BC who received EBRT did not have a significantly higher risk for CAD when compared to their right-sided counterparts (HR = 0.73, 95% CI: 0.34 – 1.54, p = 0.402).
Our study suggests a historical trend of increased CAD in BC patients receiving left-sided EBRT. Data from patients diagnosed after 2010 in our institutional cohort did not show a significant difference, emphasizing that modern EBRT regimens are safe, and laterality of BC does not affect CAD outcomes in the short term after a breast cancer diagnosis.”
Sources: Anant Madabhushi/Linkedin.