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Radiotherapy for breast cancer and subsequent risk of cardiovascular events

Objective

There are over a million survivors of breast cancer in Europe today and this number is increasing rapidly due to increased incidence, improvements in treatment, and screening programmes. A recent overview of radiotherapy for early breast cancer showed that mortality from breast cancer was reduced in women given radiotherapy. This benefit was largely offset by the finding that women given radiotherapy experienced an increased risk of mortality from other causes, particularly cardiovascular disease. For breast cancer, improvements in radiotherapy techniques in recent years have reduced radiation doses to the heart. Many radiotherapy regimens still involve cardiac doses that may range up to a few Gy, and it seems likely that some cardiovascular risk remains with these regimens. There is thus an urgent need to obtain additional quantitative information on the size of the risk, so that it can be taken into account in the decision as to whether or not to treat a woman with radiotherapy and, if treatment is to be given, which radiotherapy regimen to use. Results from this study will provide information about the size of the cardiovascular risk from both past and present breast cancer radiotherapy regimens. This will be achieved by: (i) conducting large follow-up studies of women with breast cancer in Sweden and Denmark; (ii) developing methods to assess the radiation dose to the heart from different breast cancer radiotherapy regimens; (iii) conducting nested-case control studies within the two cohorts to establish a dose-response relationship for cardiac dose and cardiovascular risk. The information obtained about the risk of cardiovascular disease following low doses of radiation will also be of considerable practical use in other areas of radiological protection, and may be expected to contribute to the development of standards.

Topic(s)

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Call for proposal

EURATOMCALL2004-FIXEDDEADLINE
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Coordinator

KAROLINSKA INSTITUTET
EU contribution
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Address
Nobels vaeg 5
281 STOCKHOLM
Sweden

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Total cost
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Participants (4)