Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women

Darby, Sarah; McGale, Paul; Peto, Richard; Granath, Fredrik; Hall, Per; Ekbom, Anders

doi:10.1136/bmj.326.7383.256

Cited by 235Chemotherapy-induced cardiotoxicity and mitigationMultiple and Secondary Primary CancersBreast Cancer Treatment Studies

Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women

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Darby, Sarah, McGale, Paul, Peto, Richard, Granath, Fredrik, Hall, Per, Ekbom, Anders·2003·BMJ

DOI 10.1136/bmj.326.7383.256PMC PMC140764

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Abstract

Increased cardiovascular mortality more than 10 years after diagnosis of breast cancer is compatible with radiotherapy causing a substantial hazard During radiotherapy for breast cancer there is often some irradiation of the heart and major blood vessels, which could increase cardiovascular mortality many years later.1–3 The dose of radiation to the heart is generally higher when the left rather than the right breast is affected. Therefore, indirect evidence on the magnitude of any risk is available where the tumour laterality (left or right breast) can be linked to subsequent cardiovascular mortality. 1 2 Studies of the survivors of the atomic bombing of Japan who received single doses to the whole body of 0–4 Gy show that the cardiovascular disease risk is dose related and increases by about 14% per gray.4 View this table: Mortality ratio for women with left sided breast cancer versus women with right sided breast cancer during and after the first 10 …

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The incidence of ischaemic heart disease and stroke is increased many years after radiation exposure for treatment of lymphomas and for breast cancer, as well as for head and neck cancer.
“The incidence of ischaemic heart disease and stroke is increased many years after radiation exposure for treatment of lymphomas and for breast cancer, as well as for head and neck cancer.191,192”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [191]

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Self-citation

Authors: Darby, S., McGale, P., Peto, R., Granath, F., Hall, P., & Ekbom, A.
Affiliations: University of Oxford (GB)
Corresponding author: Darby, Sarah
ORCID: Darby, Sarah
McGale, Paul
Peto, Richard
Venue: BMJ
Publisher: BMJ
Published: 2003-02-01
Volume: 326
Issue: 7383
Pages: 256-257
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.326.7383.256
PMC: PMC140764
OpenAlex: W1923402600
Cited by: 235
References: 7
Citations by year: 2026: 2 · 2025: 3 · 2024: 3 · 2023: 8 · 2022: 9 · 2021: 15 · 2020: 9 · 2019: 8 · 2018: 8 · 2017: 15 · 2016: 17 · 2015: 10 · 2014: 7 · 2013: 19 · 2012: 19
FWCI: 5.05
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Keywords: breast cancer, radiotherapy, cardiovascular mortality, late radiation effects, left-sided breast cancer, radiation dose, cardiovascular disease
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Breast Neoplasms, Cardiovascular Diseases, Female, Humans, Middle Aged, Sweden, Cohort Studies, Survival Rate

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Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women

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