title: [Radiation-related heart toxicity: Update in women].
abstract: Breast cancer is a common diagnosis in women and thus women are at risk of radiation-induced heart disease, in particular during radiotherapy for left breast cancer and when the internal mammary chain is included. Rates of major cardiac events increase with younger age at the time of irradiation, diagnosis before 1990s, higher radiation doses, coexisting cardiovascular risk factors and adjuvant cardiotoxic chemotherapy. Radiation-induced heart disease comprises a spectrum of cardiac pathologies, including pericardial disease, cardiomyopathy, coronary artery disease and valvular disease. The cardiac injury can appear a long time after radiotherapy and can consist of complex lesions with poor prognosis. The disciplines of cardiology and oncology have increasingly recognized the benefits of collaborating in the care of cancer patients with cardiac disease, developing guidelines for the assessment and management of radiation-related cardiovascular disease. We could consider screening patients with previous chest radiation every 5 years with transthoracic echocardiography and functional imaging. However, prevention remains the primary goal, using cardiac sparing doses and avoidance techniques in radiotherapy to improve patient survival.
authors.affiliation: Clinique universitaire de cardiologie, centre hospitalier universitaire de Grenoble-Alpes, BP 217, 38043 Grenoble cedex 9, France. Electronic address: smarliere@chu-grenoble.fr.
authors.forename: S
authors.initials: S
authors.lastname: Marlière
authors.affiliation: Clinique universitaire de cardiologie, centre hospitalier universitaire de Grenoble-Alpes, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Vautrin
authors.affiliation: Clinique universitaire de cardiologie, centre hospitalier universitaire de Grenoble-Alpes, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Saunier
authors.affiliation: Service de cancérologie-radiothérapie, centre hospitalier universitaire de Grenoble-Alpes, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Chaikh
authors.affiliation: Service de cancérologie-radiothérapie, centre hospitalier universitaire de Grenoble-Alpes, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: I
authors.initials: I
authors.lastname: Gabelle-Flandin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000532:radiotherapy; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000528:radiation effects*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011879:Radiotherapy Dosage; D012737:Sex Factors
keywords: Breast cancer; Cancer du sein; Femme; Lésions cardiaques radio-induites; Radiation-induced heart disease; Radiotherapy; Radiothérapie; Toxicité cardiaque; Women