Author + information
The risk of death due to cardiac ischemia is increased in radiation-treated breast cancer survivors with left sided breast tumors. However, the findings linking radiotherapy with other causes of cardiac mortality in women with breast cancer receiving radiation have been inconsistent. Thus, we sought to determine whether race, laterality and localization of breast cancer affect the development of heart failure in breast cancer survivors receiving radiation.
We utilized the US Surveillance Epidemiology and End Results (SEER) cancer registries linked with-Medicare data to identify cardiac failure in women diagnosed with breast cancer who were irradiated. Cox regression analysis was performed to determine the effect of race, laterality and localization of breast cancer on the risk of heart failure in irradiated breast cancer survivors.
From 1976-2007, 8025 women with breast cancer received radiation. About 13% were later diagnosed with heart failure, of whom 81% were white, 13% were black and 6% of other origin, including Asian and Hispanic. The risk of heart failure was similar in left- vs right-sided breast cancer. Outer quadrant cancers were most commonly associated with heart failure (51%). In multivariable Cox models, race was significantly associated with heart failure, blacks having a higher risk of developing heart failure than whites (Hazard Ratio 1.4; 95% Confidence Interval, 1.2-1.7; p=0.0006) after adjustment for age, year of treatment, year of diagnosis, diabetes, hypertension, chemotherapy and cardioprotective drugs. Further stratification of localization of breast cancer into left- versus right-sided laterality showed no association to heart failure.
Black women who received radiation for breast cancer have a higher risk of developing heart failure compared to whites. Grouping localization of breast cancer into left- versus right-sided laterality does not appear to affect risk of heart failure.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Dilated Cardiomyopathies: From Peripartum, Cancer Therapy, Familial Cardiomyopathies to Cardiac Amyloidosis
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1134-276
- 2013 American College of Cardiology Foundation