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conferenceseries
.com
Volume 2, Issue 4 (Suppl)
Breast Can Curr Res, an open access journal
Breast Pathology 2017
August 23-24, 2017
August 23-24, 2017 Toronto, Canada
4
th
World Congress on
Breast Pathology and Cancer Diagnosis
Cardiac toxicity after radiotherapy for breast cancer: a cardiovascular update
Nneka C Onwudiwe
CDER- US Food and Drug Administration, USA
R
adiotherapy (RT) in the treatment of breast cancer uses ionizing radiation to kill malignant cells. Radiation treatment
following breast cancer surgery-breast conserving surgery (BCS) or mastectomy-is associatedwith significant improvement
in locoregional control. However, the beneficial effects of RT in reducing breast cancer death and recurrence are offset by the
increased risk of cardiac toxicity. Radiation-induced cardiac toxicity is a well-documented sequela of radiation treatment that
can occur immediately, or manifest months or years after completion of radiation therapy. The damaging effects to any structure
of the heart, including the pericardium, vasculature, myocardium, valves, and conduction system depends on total dose of
radiation received by the heart, volume of the heart exposed, and radiation technique used. Another factor that potentiates the
risk of cardiac toxicity is whether patients are receiving RT for left-sided breast cancer vs. those receiving RT for right-sided
tumors. The damaging effects include: acute and chronic pericarditis, pericardial effusion, constrictive pericarditis, coronary
artery disease, cardiomyopathy, valvular heart disease, conduction system abnormalities, etc. Techniques to limit radiation
exposure such as image-guided therapy; 3-dimensional treatment planning; respiratory gating; and intensity modulated RT,
enables the selection of the most optimum treatment method when planning and administering RT. However, understanding
patients’ risk of an event and stratifying patients according to cardiovascular risk for these events would be useful in identifying
those patients most likely to benefit from management plans, as well as strategies to reduce cardiotoxicity.
nonwudiwe@gmail.com