Left Breast Radiation May Damage Heart Arteries

Whole Breast Radiation Art © Pam Stephan

Radiation for breast cancer can prevent the disease from recurring, but it can sometimes damage arteries leading to your heart. If the tender lining of those arteries absorbs radiation, those important channels can narrow over time, a condition called coronary artery stenosis. If that shrinkage becomes severe, blockage can occur.  Blocked arteries can be treated with a coronary angiography procedure, to restore proper circulation to your body.

Dr. Greger Nilsson, of Uppsala University Hospital in Sweden published the results of a study covering breast cancer patients from 1970 and 2003.  His research was published in the Dec. 27 online edition of the Journal of Clinical Oncology. The overall risk of coronary artery disease from breast radiation is relatively small - from a group of 8,190 women only 199 needed treatment for blocked arteries. This results may be due to the long period of time covered in the study and the gradual improvement of radiation methods.

Although whole breast or partial breast radiation is carefully planned and aimed as accurately as possible, it is sometimes impossible to avoid exposure to nearby tissues such as skin, chest muscles, ribs, lungs, and heart. Radiation treatments may also be given internally through an implanted catheter - a technique called breast brachytherapy. All radiation treatments are designed to kill cancer cells or shrink tumors, but due to the broadcasting nature of radiation, it does affect healthy tissue as well.  There are tradeoffs with most kinds of cancer treatments, but for many patients, the benefits outweigh the risks of recurrence and side effects.

Modern breast radiation procedures are more targeted and less risky than they were 30 or 40 years ago. Patients who are struggling with a choice between a lumpectomy or a mastectomy as well as radiation don't always need to base their surgical decision on prospective follow-up treatments.  Dr. Timothy Zagar, a radiation oncologist said, ""I don't think this study's findings would justify changing from a lumpectomy [breast-conserving surgery] to a mastectomy [surgical removal of the breast]. Breast-conserving therapy is very important to many women, and the number of coronary events are still low."