Key result
Post-radiotherapy cutaneous telangiectasiae linked to ~6-fold higher cardiovascular disease risk in breast cancer.
Why the study?
Although large studies have shown increased risks of cardiovascular disease after breast radiotherapy, the role of cutaneous telangiectasiae as a predictor of radiation-induced heart disease was unknown.
Does the presence of cutaneous telangiectasiae predict cardiovascular disease in women receiving radiotherapy for breast cancer?
Cohort (n=149)
Yes
Does the presence of cutaneous telangiectasiae predict cardiovascular disease in women receiving radiotherapy for breast cancer?
Odds Ratio: 6.3 (95% CI 1.4–28.5)
Absolute Event Rate: 15.6% vs 2.9%
p-value: p=0.017
Cutaneous telangiectasiae may serve as a clinical marker for future radiation-induced cardiac complications in breast cancer patients.
Skin telangiectasiae were associated with higher CVD risk after breast radiotherapy; hypothesis-generating marker that requires prospective validation before clinical use.
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). INTERPRETATION: 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.
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Tanteles et al. (2009) conducted a cohort in Breast cancer (post-radiotherapy) (n=149). Cutaneous telangiectasiae vs. Absence of cutaneous telangiectasiae was evaluated on Cardiovascular disease (CVD) (OR 6.3, 95% CI 1.4-28.5, p=0.017). The presence of cutaneous telangiectasiae following breast cancer radiotherapy was associated with a significantly increased long-term risk of cardiovascular disease (OR 6.3).
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