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Area of Science:

  • Oncology
  • Cardiology
  • Radiation Oncology

Background:

  • Cardiotoxicity is a significant concern following breast cancer treatment.
  • Identifying risk factors for cardiac events is essential for patient management.

Purpose of the Study:

  • To investigate clinical factors, coronary artery calcium (CAC), and radiation dose as predictors of cardiotoxicity.
  • To understand the risk of significant cardiac events (grade ≥3) post-radiation therapy.

Main Methods:

  • Retrospective analysis of 174 breast cancer patients treated with neoadjuvant chemotherapy (2005-2014).
  • Assessment of cardiac event incidence, adjusting for competing risks.
  • Evaluation of coronary artery calcium (CAC) and radiation dose to cardiac structures.

Main Results:

  • The 10-year incidence of grade ≥3 cardiac events was 8.5%.
  • Patients with nodal positive disease had a 3.30-fold increased likelihood of cardiac toxicity.
  • Nodal positivity remained a significant risk factor after multivariable adjustment.

Conclusions:

  • Low coronary artery calcium burden and radiation doses were associated with low cardiotoxicity rates.
  • Nodal positive breast cancer patients represent a high-risk subgroup for cardiotoxicity.
  • Close follow-up and optimized therapies are recommended for nodal positive patients.