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 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 View this table: Mortality ratio for women with left sided breast cancer versus women with right sided breast cancer during and after the first 10 …