title: Less increase of CT-based calcium scores of the coronary arteries : Effect three years after breast-conserving radiotherapy using breath-hold.
abstract: OBJECTIVE
  The aim of this prospective longitudinal study was to compare coronary artery calcium (CAC) scores determined before the start of whole breast irradiation with those determined 3 years afterwards.
  
  
  METHODS
  Changes in CAC scores were analysed in 99 breast cancer patients. Three groups were compared: patients receiving left- and right-sided radiotherapy, and those receiving left-sided radiotherapy with breath-hold. We analysed overall CAC scores and left anterior descending (LAD) and right coronary artery (RCA) CAC scores. Between the three groups, changes of the value of the LAD minus the RCA CAC scores of each individual patient were also compared.
  
  
  RESULTS
  Three years after breath-hold-based whole breast irradiation, a less pronounced increase of CAC scores was noted. Furthermore, LAD minus RCA scores in patients treated for left-sided breast cancer without breath-hold were higher when compared to LAD minus RCA scores of patients with right-sided breast cancers and those with left-sided breast cancer treated with breath-hold.
  
  
  CONCLUSIONS
  Breath-hold in breast-conserving radiotherapy leads to a less pronounced increase of CT-based CAC scores. Therefore, breath-hold probably prevents the development of radiation-induced coronary artery disease. However, the sample size of this study is limited and the follow-up period relatively short.
authors.affiliation: Radiotherapy, Centre West, Lijnbaan 32, 2501 CK, The Hague, The Netherlands. m.mast@mchaaglanden.nl.
authors.forename: M E
authors.initials: ME
authors.lastname: Mast
authors.affiliation: Department of radiology, Medical Center Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: Heijenbrok
authors.affiliation: Radiotherapy, Centre West, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: M L
authors.initials: ML
authors.lastname: van Kempen-Harteveld
authors.affiliation: Radiotherapy, Centre West, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: A L
authors.initials: AL
authors.lastname: Petoukhova
authors.affiliation: Department of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors.forename: A N
authors.initials: AN
authors.lastname: Scholten
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Wolterbeek
authors.affiliation: Department of Cardiology, Medical Center Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: J H M
authors.initials: JH
authors.lastname: Schreur
authors.affiliation: Radiotherapy, Centre West, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.|Department of Clinical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Struikmans
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D062485:Breath Holding; D015984:Causality; D015897:Comorbidity; D000072226:Computed Tomography Angiography / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012307:Risk Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*
keywords: Atherosclerotic plaque; Breast cancer; Cardiovascular disease; Coronary arteries; Coronary artery disease