Before I started treatments for breast cancer, I consulted a radiologist.
He asked about my diagnosis, explained how radiation treatments could
help, and then did an examination. When his exam was done, he said,
"You're lucky - you are pigeon-breasted, so radiation to the breast will
most likely miss your heart and lungs. That's a risk we have to
consider. We could kill your cancer, but your heart might receive some
damage and your left lung might develop some stiffness." Oh nice, I
thought, just more risks that I wanted to hear about!
A new study has come out in the New England Journal of Medicine that confirms my radiologist's concerns. Women who have radiation for breast cancer run a higher than average risk of later developing heart disease or having a heart attack. This risk starts to be apparent from 5 years after treatment and runs until 20 years later. If the left breast - closest to the heart - received radiation, then the risk increases. The study is based on older data, and may not reflect the current standard of care. Women in this study were treated between 1958 and 2001 with radiation for breast cancer. Newer and more targeted radiation techniques use less radiation and more shielding of internal organs, which increases patient safety.
Dr. Sarah Darby, who led the study from Oxford University, said that patients should not skip radiation treatments because of this research. "Doctors can now estimate the risk and know that in most cases it will be very small so they can reassure their patients," she said, ""The results of our study should not scare women off having radiotherapy," she told Reuters Health in an email. "It is a life-saving procedure."
If a women has a risk for heart disease before she develops breast cancer, she should let her oncologist know. Treatments can be designed to minimize exposure to her heart and she should be carefully monitored during and after radiation. Her radiologist might even recommend brachytherapy instead of external beam radiation. There are also ways to track lifetime radiation exposure, or monitor the dose via an implanted dosimeter.
A new study has come out in the New England Journal of Medicine that confirms my radiologist's concerns. Women who have radiation for breast cancer run a higher than average risk of later developing heart disease or having a heart attack. This risk starts to be apparent from 5 years after treatment and runs until 20 years later. If the left breast - closest to the heart - received radiation, then the risk increases. The study is based on older data, and may not reflect the current standard of care. Women in this study were treated between 1958 and 2001 with radiation for breast cancer. Newer and more targeted radiation techniques use less radiation and more shielding of internal organs, which increases patient safety.
Dr. Sarah Darby, who led the study from Oxford University, said that patients should not skip radiation treatments because of this research. "Doctors can now estimate the risk and know that in most cases it will be very small so they can reassure their patients," she said, ""The results of our study should not scare women off having radiotherapy," she told Reuters Health in an email. "It is a life-saving procedure."
If a women has a risk for heart disease before she develops breast cancer, she should let her oncologist know. Treatments can be designed to minimize exposure to her heart and she should be carefully monitored during and after radiation. Her radiologist might even recommend brachytherapy instead of external beam radiation. There are also ways to track lifetime radiation exposure, or monitor the dose via an implanted dosimeter.
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