Can cutaneous telangiectasiae as late normal-tissue injury predict cardiovascular disease in women receiving radiotherapy for breast cancer?
BACKGROUND
Overall, approximately 5% of patients show late normal-tissue damage after radiotherapy with a smaller number having a risk of radiation-induced heart disease. Although the data are conflicting, large studies have shown increased risks of cardiovascular disease (CVD) for irradiated patients compared with non-irradiated ones, or for those treated to the left breast or chest wall compared with those treated to the right. Cutaneous telangiectasiae as late normal-tissue injury have so far only been regarded as a cosmetic burden.


METHODS
The relationship between late normal-tissue radiation injury phenotypes in 149 irradiated breast cancer patients and the presence of cardiovascular disease were examined.


RESULTS
A statistically significant association between the presence of skin telangiectasiae and the long-term risk of CVD was shown in these patients (P=0.017; Fisher's exact test).


CONCLUSIONS
This association may represent initial evidence that telangiectasiae can be used as a marker of future radiation-induced cardiac complications. It could also suggest a common biological pathway for the development of both telangiectasiae and CVD on the basis of a genetically predisposed endothelium. To our knowledge this is the first reported study looking at this association.
Tanteles
G A
GA
Department of Genetics, University of Leicester, Leicester LE1 5WW, UK.
Whitworth
J
J
Mills
J
J
Peat
I
I
Osman
A
A
McCann
G P
GP
Chan
S
S
Barwell
J G
JG
Talbot
C J
CJ
Symonds
R P
RP
D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D002318:Cardiovascular Diseases / Q000209:etiology*; D048909:Diabetes Complications / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D011878:Radiotherapy / Q000009:adverse effects*; D012867:Skin / Q000098:blood supply / Q000528:radiation effects*; D012907:Smoking / Q000009:adverse effects; D013684:Telangiectasis / Q000209:etiology*