title: Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005.
abstract: The risk of heart disease subsequent to breast cancer radiotherapy was examined with particular focus on women receiving anthracycline-containing chemotherapy.
  
  
  
  Women diagnosed with early-stage breast cancer in Denmark, 1977-2005, were identified from the register of the Danish Breast Cancer Cooperative Group, as was information on cancer-directed treatment. Information on heart disease was sought from the Danish National Patient and Cause of Death Registries. Incidence rate ratios were estimated comparing left-sided with right-sided cancer (IRR, LvR), stratified by calendar year, age, and time since breast cancer radiotherapy.
  
  
  
  Among 19,464 women receiving radiotherapy, the IRR, LvR, was 1.11 (95% CI 1.03-1.20, p=0.005) for all heart disease and among those also receiving anthracyclines the IRR, LvR, was 1.32 (95% CI 1.02-1.70, p=0.03). This risk was highest if the treatment was given before the age of 50years (IRR, LvR, 1.44, (95% CI 1.04-2.01) but there was no significant trend with age or time since treatment.
  
  
  
  Radiotherapy for left-sided breast cancer is associated with a higher risk of heart disease than for right-sided with the largest increases seen in women who also received anthracycline-containing chemotherapy.
authors.affiliation: Department of Oncology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark.
authors.forename: Jens Christian
authors.initials: JC
authors.lastname: Rehammar
authors.affiliation: Danish Breast Cancer Cooperative Group Secretariat, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors.forename: Maj-Britt
authors.initials: MB
authors.lastname: Jensen
authors.affiliation: Nuffield Department of Population Health, University of Oxford, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: McGale
authors.affiliation: Department of Oncology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark.
authors.forename: Ebbe Laugaard
authors.initials: EL
authors.lastname: Lorenzen
authors.affiliation: Nuffield Department of Population Health, University of Oxford, United Kingdom.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Taylor
authors.affiliation: Nuffield Department of Population Health, University of Oxford, United Kingdom.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Darby
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Videbæk
authors.affiliation: Nuffield Department of Population Health, University of Oxford, United Kingdom; Medical Research Council Population Health Research Unit, University of Oxford, United Kingdom.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Oncology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark. Electronic address: Marianne.ewertz@rsyd.dk.
authors.forename: Marianne
authors.initials: M
authors.lastname: Ewertz
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D012306:Risk; D013997:Time Factors
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic
keywords: Anthracyclines; Breast cancer; Heart disease; Radiotherapy