Douglas Kelly, MD
In March, The New England Journal of Medicine published an article detailing the link between breast radiation and ischemic heart disease, which includes heart attacks and bypass graft surgery. The article determined that even low dosages of radiation to the heart pose some danger. The increased risk of heart problems started within five years after radiation therapy and continued for at least 20 years. Women with other cardiac risk factors were especially vulnerable.
It is important to point out that the study was done on women who received radiation therapy between 1958 and 2001. Radiation technology has improved quite remarkably over the past 10-20 years. Most women treated today in the United States receive lower amounts of radiation to the heart than women did at the time of the study.
It is also important to remember that research studies have consistently shown that using radiation therapy when appropriate improves the life expectancy of breast cancer patients. Overall, more women benefit from radiation treating their cancer than those who are harmed by an increased chance of death from other causes such as heart attacks.
As an informed patient you should not be afraid to ask if there are technologies and techniques that can lower the radiation dosage to your heart. In my practice, I’ve encountered many women concerned about this issue. Usually, they are reassured after we discuss the risks and benefits. Some women with stage I breast cancer can have a portion of the breast treated after a lumpectomy instead of the entire breast, which results in a lower dosage of radiation.
An exciting new treatment option at Cancer Treatment Centers of America is intraoperative radiation therapy (IORT). After the lump is removed, radiation is directed only to the area of the breast where the tumor was removed while the patient is still under an anesthetic in the operating room.
Thankfully, today more breast cancer patients are becoming long-term survivors. Breast cancer patients who have heart disease should be carefully monitored and treated for these problems before radiation starts and throughout their lives.