Risk Factors of Cardiotoxicity After Breast Cancer Radiotherapy

This is a retrospective analysis investigating the risk factors for Cardiotoxicity after breast cancer radiotherapy. A cohort of 174 patients with stage I-III breast cancer was analyzed with a median follow-up of 117 months, observing a low 10-year cumulative incidence of grade >= 3 cardiac events at 8.5%. The researchers used the U.S. Food and Drug Administration-approved AVIEW CAC (Coreline Soft) program on CT imaging to generate Agatston CAC scores. Multivariable analysis identified nodal positive disease as a significant predictor of Cardiotoxicity (HR: 3.30, P<0.05). Patients with nodal positivity had more than three times the increased risk of Cardiotoxicity and were associated with more intensive regimens like RNI, anthracyclines, and hormonal therapy, and greater radiation dose to vulnerable cardiac structures. Close follow-up is therefore recommended for this high-risk subgroup.