Description

Darby et al identified risk factors for ischemic heart disease following radiation therapy for breast cancer. These can help to identify a woman who may benefit from more aggressive management. The authors are from multiple institutions in Europe and the United States.


Patient selection: woman receiving radiation therapy for breast cancer

 

Time course: onset may be within a few years of therapy to decades later

 

Risk factors for ischemic heart disease:

(1) cancer in the left breast (OR 1.3)

(2) higher mean radiation dose to the heart

(3) past history of ischemic heart disease (OR 6.7)

(4) history of other circulatory disease (OR 1.9)

(5) history of COPD (OR 6.3)

(6) current smoker (OR 1.9)

(7) history of regular analgesic use (OR 1.7)

(8) obesity (BMI >= 30 kg per square meter; OR 1.6)

(9) diabetes (OR 3.2)

(10) not receiving hormone replacement therapy (OR 1.5)


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