Abstract 4044
Background
Radiotherapy halves the recurrence risk and reduces breast cancer death after breast sparing surgery, but it is associated cardiac morbidity and mortality (1). The EBCTCG data demonstrates an excess cardiac mortality rate ratio of 4,1% per increased Gray (Gy) whole heart dose (2). The aim of this study is to create a clinical applicable risk assessment model to predict 10-year cardiovascular mortality in female breast cancer patients.
Methods
By integration of the SCORE (Systematic COronary Risk Evaluation) risk charts and data of the EBCTCG we were able to develop cardiovascular mortality risk charts based on mean heart dose, age, systolic blood pressure, smoking-status and cholesterol for high- and low-risk regions in Europe, for contemporary mean heart doses of 2Gy, 4Gy and 8Gy.
Results
We will present tables showing the 10-year cardiovascular mortality based on mean heart dose, smoking status, age, systolic blood pressure and cholesterol for high- and low-risk regions in Europe. Below you find the risk table for 60-years old non-smoking women in low-risk regions. A 60-year old, non-smoking patient from France (low-risk region) with a cholesterol 220 mg/dl and a systolic blood pressure of 140 mmHg has a 10-year cardiovascular mortality risk of 1,0%, adding radiotherapy with a mean heart dose of 4Gy will increase it to 1,1% and doubling the heart dose to 8Gy results in a risk of 1,2%. In contrast, a 65 year old smoking patient living in Bosnia (high-risk region) with a cholesterol of 260 and a systolic blood pressure of 160 mmHg has a 10-year cardiovascular mortality risk of 13,0%, adding radiotherapy with a mean heart dose of 4Gy will increase it to 14,3% and doubling the heart dose to 8Gy results in a risk of 15,7%.Table:
189P
Cholesterol: 200-250 mg/ml Mean Heart Dose | Cholesterol: 250-300 mg/ml Mean Heart Dose | |||||||
---|---|---|---|---|---|---|---|---|
SBP | 0Gy | 2Gy | 4Gy | 8Gy | 0Gy | 2Gy | 4Gy | 8Gy |
180 mmHg | 3,0 | 3,2 | 3,3 | 3,6 | 4,0 | 4,2 | 4,4 | 4,9 |
160 mmHg | 2,0 | 2,1 | 2,2 | 2,4 | 2,0 | 2,1 | 2,2 | 2,4 |
140 mmHg | 1,0 | 1,1 | 1,1 | 1,2 | 2,0 | 2,1 | 2,2 | 2,4 |
120 mmHg | 1,0 | 1,1 | 1,1 | 1,2 | 1,0 | 1,1 | 1,1 | 1,2 |
Conclusions
Integrating cardiovascular risk tables and radiotherapy data are useful for patient individualized radiotherapy and cardiovascular prevention after breast cancer treatment. (1) Lancet 2011;378(9804):1707-16. (2) J Clin Oncol 2017;35(15):1641-1649.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Vrije Universiteit Brussel.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
869 - Impact of Education for Breast self examination in Rural Indian Women on Early Detection - results of POC study
Presenter: Sneha Parchuri
Session: Poster Display session 2
Resources:
Abstract
1951 - Breast cancer incidence and survival in renal transplant patients: 35-year experience
Presenter: Michalis Kontos
Session: Poster Display session 2
Resources:
Abstract
2017 - The changing landscape of breast cancer incidence after treatment for Hodgkin’s disease
Presenter: Amelia Benjamin
Session: Poster Display session 2
Resources:
Abstract
1780 - Number of deliveries as a prognostic factor in different breast cancer subtypes
Presenter: Anniina Jääskeläinen
Session: Poster Display session 2
Resources:
Abstract
4650 - Effects of supervised and adapted exercise program in the quality of life and strength of breast cancer survivors: MAMA MOVE Gaia trial
Presenter: Ana Joaquim
Session: Poster Display session 2
Resources:
Abstract
4962 - Study On the Socioeconomic and Clinical Factors Affecting the Proportion of Breast Conserving Surgery in Chinese Women Breast Cancer
Presenter: Jin Zhang
Session: Poster Display session 2
Resources:
Abstract
5451 - Clinical decision making and multidisciplinary team meetings (MDMs) in early breast cancer. Is the agreement between planned and applied therapeutic program?
Presenter: Marco Giavarra
Session: Poster Display session 2
Resources:
Abstract
888 - The value of genetic counselling in breast cancer genetic testing and clinical management
Presenter: Vicki Kiesel
Session: Poster Display session 2
Resources:
Abstract
4005 - Elderly patients in the Japanese Breast Cancer Registry
Presenter: Masataka Sawaki
Session: Poster Display session 2
Resources:
Abstract
3330 - Tumour-infiltrating lymphocytes and BRCA-like status in stage III breast cancer patients treated with intensified carboplatin-based chemotherapy
Presenter: Leonora De Boo
Session: Poster Display session 2
Resources:
Abstract