- Coronary artery calcification (CAC) scores derived from radiotherapy planning scans may be valuable for estimating the risk for cardiovascular disease (CVD) in patients with breast cancer.
Why this matters
- CVD accounts for almost 20% of the total deaths among breast cancer survivors.
- CAC is sometimes incidentally observed during radiotherapy planning CT scans.
- Retrospective analysis of 15,919 patients with breast cancer who underwent radiotherapy planning CT scans during 2004-2016 at 3 Dutch institutions.
- Funding: Dutch Cancer Society; European Commission; Dutch Digestive Foundation; Netherlands Organisation for Scientific Research.
- 70% of women had no calcium detected in their coronary arteries (CAC score of 0), whereas 3% were in the highest category (CAC score of >400).
- Incidence of nonfatal and fatal CVD events increased with higher CAC scores:
- 0: 5.1%.
- 1-10: 8.5%.
- 11-100: 13.5%.
- 101-400: 17.6%.
- >400: 28.0%.
- After adjustment for age, laterality of radiation, and receipt of cardiotoxic chemotherapy agents, CAC score >400 vs score 0 was associated with sharply increased adjusted HRs for:
- CVD events: 3.7.
- Coronary heart disease events: 8.2.
- Any cause mortality: 2.8.
- In a survey, 90% of women said they wanted to be informed about their CAC score and associated CVD risk.
- Retrospective design.