BMJ 2003;326:256-257 ( 1 February )

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Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women

Increased cardiovascular mortality more than 10 years after diagnosis of breast cancer is compatible with radiotherapy causing a substantial hazard

Sarah Darby, professor ^a, Paul McGale, statistician ^a, Richard Peto, codirector ^a, Fredrik Granath, statistician ^b, Per Hall, professor ^b, Anders Ekbom, professor ^c. 

^a Clinical Trial Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford OX2 6HE, ^b Department of Medical Epidemiology, Karolinska Institute, 171 77 Stockholm, Sweden, ^c Department of Medicine, Karolinska Institute

Correspondence to: S Darby
sarah.darby@ctsu.ox.ac.uk

The first 150 words of the full text of this article appear below.

During radiotherapy for breast cancer there is often some irradiation of the heart and major blood vessels, which could increase cardiovascular mortality many years later.^1-3 The dose of radiation to the heart is generally higher when the left rather than the right breast is affected. Therefore, indirect evidence on the magnitude of any risk is available where the tumour laterality (left or right breast) can be linked to subsequent cardiovascular mortality. ^{1 2} Studies of the survivors of the atomic bombing of Japan who received single doses to the whole body of 0-4 Gy show that the cardiovascular disease risk is dose related and increases by about 14% per gray.⁴

Table Removed (Available Only in the Full Text)

	Participants, methods, and results

Since 1970, the nationwide Swedish cancer registry has recorded the laterality of breast cancers but not the use of radiotherapy. Unpublished data from regional Swedish registries suggest that about 30% of women with early breast cancer during the 1970s and early '80s received radiotherapy. . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Increased cardiovascular deaths following radiotherapy over 10 years ago - nothing new

Adrian N Harnett
bmj.com, 14 Feb 2003 [Full text]

cardiac mortality and breast radiotherapy

Ian H kunkler
bmj.com, 15 Feb 2003 [Full text]

The mortality from cardiovascular disease from breast cancer radiotherapy will become history

Simon S Lo, et al.
bmj.com, 21 Aug 2003 [Full text]

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