New data question the role radiation therapy plays in cardiovascular health
Contrary to findings of prior research, radiation therapy may not affect the presence of breast arterial calcifications on imaging in women who have been treated for breast cancer.
There has been back-and-forth among experts on the relationship between breast arterial calcifications (BACs) and cardiovascular disease for years, with many now accepting the presence of BACs as a marker of CVD. Prior studies have indicated that undergoing radiation therapy could increase a woman’s risk of cardiac mortality, but now, two new studies have provided additional evidence.
A poster presented during the annual meeting of the American Roentgen Ray Society briefly details researchers’ efforts to find associations between radiation therapy and the presence of BACs. Experts retrospectively reviewed more than 1,000 electronic health records of women ages 40 to 75 who had undergone breast cancer screening over a 1-year timeframe, while two breast radiologists examined the imaging for the presence of BACs.
Among the group, 19.2% had BACs on imaging, while 10.6% had undergone radiation therapy at some point. Of the radiation therapy group, 32% showed BACs on their mammogram within two years of completing treatment. While women exposed to radiation treatments were at greater risk of showing BACs on subsequent mammograms, the team did not find the difference in rates to be statistically significant, with the maximally adjusted model demonstrating an odds ratio of 1.52.
“Our study is the first retrospective analysis of the association between breast cancer radiation therapy exposure and the presence of breast arterial calcification on screening mammography,” presenter Jessica Rubino, MD, from Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, noted.
Another study published this week in the European Heart Journal suggests radiotherapy actually may help combat the risk of developing cardiovascular disease and could significantly improve a woman’s long-term heart health. For that study, women underwent coronary CT angiography treatment both before and two years after completing radiotherapy.
Post-treatment imaging revealed significantly reduced inflammation as measured by fat attenuation index scores. Experts involved in the study argued that this displays the potential for radiotherapy to reduce the long-term risk of cardiac mortality. In fact, the average eight-year predicted risk for cardiac mortality in the group, as measured by an AI-risk prognostic model, dropped from 10.41% before radiotherapy to 8.92% two years after.
“High radiation doses have been proposed to harm the coronary arteries and increase the risk of heart attacks statistically,” corresponding author Charalambos Antoniades, MD, PhD, chair of cardiovascular medicine at the University of Oxford, told Cardiovascular Business. “That was believed to be because of direct damage of the heart arteries by the X-rays passing through them. However, the low radiation doses used today do not appear to have these direct detrimental effects on the heart. By treating the tumor, radiotherapy actually protects the heart!”
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.