Evaluation of radiation – Induced carotid artery stenosis after supraclavicular irradiation in patients with breast carcinoma

Saber, Amani; Kader, Moustafa Abdel; Samra, Manal F. Abu

doi:10.1016/j.ejrnm.2018.05.010

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…In addition, it has been related to cardiotoxicity through injury of cardiac myocytes and antimetabolites, which is associated with myocardial ischemia [ 6 ]. Adjuvant radiotherapy for breast cancer has also been linked to vascular pathology [ 7 ], including carotid stenosis [ 8 , 9 ], and carotid stiffness [ 10 ], as well as to an increased risk of stroke [ 11 ]. In addition, breast cancer patients may have a higher risk of congestive heart failure and myocardial infarction that can persist up to 20 years after treatment [ 1 , 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term effects of adjuvant treatment for breast cancer on carotid plaques and brain perfusion

Koppelmans

Willik

Aleman

et al. 2020

Breast Cancer Res Treat

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Purpose Breast cancer treatment has been associated with vascular pathology. It is unclear if such treatment is also associated with long-term cerebrovascular changes. We studied the association between radiotherapy and chemotherapy with carotid pathology and brain perfusion in breast cancer survivors. Methods We included 173 breast cancer survivors exposed to radiotherapy and chemotherapy, assessed ± 21.2 years after cancer diagnosis, and 346 age-matched cancer-free women (1:2) selected from the population-based Rotterdam Study. Outcome measures were carotid plaque score, intima-media thickness (IMT), total cerebral blood flow (tCBF), and brain perfusion. Additionally, we investigated the association between inclusion of the carotid artery in the radiation field (no/small/large part), tumor location, and these outcome measures within cancer survivors. Results Cancer survivors had lower tCBF (− 19.6 ml/min, 95%CI − 37.3;− 1.9) and brain perfusion (− 2.5 ml/min per 100 ml, 95%CI − 4.3;− 0.7) than cancer-free women. No statistically significant group differences were observed regarding plaque score or IMT. Among cancer survivors, a large versus a small part of the carotid artery in the radiation field was associated with a higher IMT (0.05, 95%CI0.01;0.09). Also, survivors with a right-sided tumor had lower left carotid plaque score (− 0.31, 95%CI − 0.60;− 0.02) and higher brain perfusion (3.5 ml/min per 100 ml, 95%CI 0.7;6.2) than those with a left-sided tumor. Conclusions On average two decades post-diagnosis, breast cancer survivors had lower tCBF and brain perfusion than cancer-free women. Also, survivors with a larger area of the carotid artery within the radiation field had a larger IMT. Future studies should confirm if these cerebrovascular changes underlie the frequently observed cognitive problems in cancer survivors.

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