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Paper: Cardiovascular disease incidence after internal mammary chain irradiation and anthracycline-based chemotherapy for breast cancer
Corresponding author: Naomi Boekel
Telephone: +31205126292
E-mail: [email protected]

Author summary: Both radiotherapy and anthracycline-based chemotherapy are commonly used and highly effective breast cancer treatments. Unfortunately, they have also been associated with increased cardiovascular disease (CVD) risks. We studied the separate and combined effects of various treatments and established cardiovascular risk factors on the long-term risks of different CVDs in 14,645 breast cancer patients.

During 1970-2009, especially irradiation of the lymph nodes behind the sternum (IMC-irradiation) exposed the heart to high heart doses. This type of radiation is associated with ~2-fold increased rates of different CVDs compared to women receiving the lowest cardiac doses. In patients with an established cardiovascular risk factor, 20-year cumulative incidence of ischemic heart disease is 11% in patients with IMC-irradiation versus 6% in those without. Anthracyclines are


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