A case-control study in the New England Journal of Medicine provides new information on the link between breast irradiation and increased risk for ischemic heart disease.

Using national registries, researchers in Sweden and Denmark studied nearly 2200 women who underwent radiotherapy for breast cancer between 1958 and 2001; roughly 1000 who subsequently had a major coronary event were matched with 1200 controls.

The rate of coronary events increased with the mean estimated dose of radiation to the heart. The risk increase was observed within 5 years after treatment and lasted for at least 20 years. The absolute risk for coronary events was particularly high for women who had preexisting cardiac risk factors.

In Journal Watch Oncology and Hematology, William Gradishar concludes: “Efforts to provide women with the option of breast conservation should not be abandoned, but for select women with very significant cardiac risk factors … a mastectomy might be a better option.”

Source: NEJM