Catherine Park, Presenter: Nothing to Disclose

Eleanor Harris, Abstract Co-Author: Nothing to Disclose

Left-sided breast irradiation has been associated with increased risk of cardiac mortality and morbidity in some studies. Women with ductal carcinoma in situ (DCIS) of the breast essentially have a normal life expectancy, so treatment related toxicities are particularly critical to characterize. This study examines the cardiac toxicity of irradiation in left versus right-sided DCIS patients.

The medical records of 87 patients with DCIS treated with breast conservation therapy at the Moffitt Cancer center from 1988 to 2002 were reviewed for patient and treatment characteristics, and follow up data regarding subsequent breast cancer and cardiac events were recorded. Median follow up time was 7 years (range 2 to 19 years).

There were 40 left sided (46%) and 47 right-sided (54%) patients treated. Median age was 57 years (range 33 to 84 years). There were no fatal cardiac events in the follow up period. There were 10 cases (11.5%) of local breast cancer recurrences. When morbidities were examined, there was no statistical difference between left and right-sided patients who began using any cardiac medications after radiation (22.5% vs. 21% respectively, p=0.89). There was no difference between left and right-sided patients in new diagnoses of coronary artery disease (7.5% vs. 2.1%, respectively, p= 0.23), hypertension (20% vs 12.8% respectively, p=0.44) or myocardial infarction (2.5% vs. 0%, respectively, p=0.28) post-irradiation. There was an increase in new diagnoses of chest pain in left sided (7.5%) compared to right sided (0%) patients (p=0.056).

At seven years median follow-up, there were no significant differences in cardiac mortality between right and left-sided DCIS patients treated with breast conservation treatment but there was an association with a higher rate of chest pain in patients treated for left-sided breast cancer. Longer follow up will be required to ascertain whether late events are more prevalent in left sided patients.

Park, C, Harris, E, Cardiac Morbidity and Mortality in Women with Ductal Carcinoma in Situ of the Breast Treated with Breast Conservation Therapy.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/7001358.html