Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 30:11:200113.
doi: 10.1016/j.ijcrp.2021.200113. eCollection 2021 Dec.

Coronary artery calcifications on breast cancer radiotherapy planning CT scans and cardiovascular risk: What do patients want to know?

Affiliations

Coronary artery calcifications on breast cancer radiotherapy planning CT scans and cardiovascular risk: What do patients want to know?

Roxanne Gal et al. Int J Cardiol Cardiovasc Risk Prev. .

Abstract

Background: Coronary artery calcifications (CAC) is a strong predictor of cardiovascular disease (CVD), which can be automatically quantified on routine breast radiotherapy planning computed tomography (CT) scans. Around 8% of patients have (very) high CAC scores and corresponding increased risks of CVD.

Aim: This study explores whether, how, and under what conditions women with breast cancer want to be informed about their CAC-based CVD risk.

Methods: A cross-sectional survey study was conducted in a random sample of UMBRELLA, a prospective breast cancer cohort. Participants (n = 79) filled out a questionnaire about their knowledge on the CVD risk following breast cancer, their interest in being informed about their CVD risk based on CAC score, and preferences on how they would want to receive this information.

Results: Most participants (66%) were not aware that the presence of CAC indicates an increased CVD risk. Participants indicated that they were not or only slightly aware of the risk of treatment-induced cardiotoxicity (48%), and that the risk of cardiotoxicity was higher in patients with pre-existing CVD risk factors (82%). The vast majority (90%) indicated that they want to be informed about in increased CAC-based CVD risk.

Conclusions: The majority of patients with breast cancer wants to be informed about their CAC-based CVD risk. With the majority of patients with breast cancer undergoing radiotherapy, and with low cost and automated options for accurate CAC measurement in planning CT scans, it is important to develop strategies to manage patients with an increased CAC-based risk of CVD.

Keywords: Breast cancer; CAC; Cardiovascular disease; Coronary artery calcifications; Patient preferences\.

PubMed Disclaimer

Conflict of interest statement

Prof. I Išgum reports grants from the Dutch Cancer Society (KWF), Pie Medical Imaging, the 10.13039/501100003958Dutch Technology Foundation, the Netherlands; 10.13039/501100001826Netherlands Organisation for Health Research and Development, the Netherlands, and the 10.13039/100002129Dutch Heart Foundation, the Netherlands, and reported being cofounder of, and shareholder in Quantib-U BV. Prof. HM Verkooijen reports research grants from the Dutch Cancer Society (KWF) and Elekta AB. The other authors made no disclosures.

Figures

Fig. 1
Fig. 1
Interest in, and reasons for and against, being informed about an increased CVD risk that is based on CAC scores as measured on radiotherapy planning CT scans.
Fig. 2
Fig. 2
Preferences for receiving information. Five participants did not answer these questions. Participants could provide more than one answer. Numbers did not add up to the total number of participants (N = 74).

References

    1. Garcia M., et al. Cardiovascular disease in women: clinical perspectives. Circ. Res. 2016;118:1273–1293. - PMC - PubMed
    1. World Health Organization . 2019. WHO | Global Health Observatory (GHO) Data.https://www.who.int/gho/en/ accessed.
    1. Pinder M.C., et al. Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J. Clin. Oncol. 2007;25:3808–3815. - PubMed
    1. McGale P., et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiother. Oncol. 2011;100:167–175. - PubMed
    1. Borger J.H., et al. Cardiotoxic effects of tangential breast irradiation in early breast cancer patients: the role of irradiated heart volume. Int. J. Radiat. Oncol. Biol. Phys. 2007;69:1131–1138. - PubMed

LinkOut - more resources