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SAN ANTONIO -- The considerable excess in cardiovascular mortality caused by older radiotherapy regimens for breast cancer appears to be greatly diminished with more modern ones, Sarah C. Darby, Ph.D., reported at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.
This was the principal conclusion of her analysis of nearly 309,000 cases of early breast cancer enrolled in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry in 1973-2001.
A total of 37% of the SEER population received radiotherapy.
Heart disease was the leading cause of death in radiotherapy-treated patients; however, a straightforward comparison of cardiovascular mortality rates in women who did or did not get radiotherapy wouldn't be appropriate, since SEER participants were not randomized to this treatment.
A better comparison would take advantage of the fact that the heart is located slightly left of center in the body; thus, radiotherapy recipients with cancer of the left breast will get a higher radiation dose than those with right-sided cancer, explained Dr. Darby of the University of Oxford (England).
Sure enough, among SEER participants who received radiotherapy and subsequently died of heart disease, there was a highly significant 16% excess of cancers of the left breast. In the subset of radiotherapy-treated patients followed for 15 years or more, this ...