Breast cancer radiotherapy planning scans inform CVD risk estimates

  • EBCC 2020
  • 25 oct. 2020

  • Par Pavankumar Kamat
  • Résumés d'articles
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Retrospective design.