Three million women in the US are breast cancer survivors. Some of these women may experience a potentially serious side effect from treatment—an increased risk of developing cardiovascular disease (CVD).

Earlier research has shown that breast cancer patients treated with radiation therapy may be at increased risk for CVD. In rare cases, women treated with the breast cancer chemotherapy drug anthracycline may suffer heart damage.

Now: In a first-of-its-kind study, researchers from the Division of Imaging and Oncology at University Medical Center Utrecht, The Netherlands, have found a simple way to predict which breast cancer survivors may be at greatest risk of developing CVD. In some women, the risk of dying from CVD may be higher than the risk of succumbing to breast cancer.

The researchers discovered that a routine chest CT scan used to plan breast cancer treatment can also measure the amount of calcium in the walls of coronary arteries. This scan can help calculate a coronary artery calcium (CAC) score, which determines the risk of cardiovascular disease (CVD). [2] These findings were presented at the 12th European Breast Cancer Conference.

Study details: In the study, which was done at three hospitals in The Netherlands between 2005 and 2016, about 14,000 breast cancer patients were followed for 52 months after their routine pre-treatment CT scans. All these women were treated with radiation therapy. After calculating CAC scores, these were the key findings…

  • In women with no calcifications (CAC score of 0), 5% went on to be hospitalized with or die from cardiovascular disease.
  • In women with CAC scores of 1 to 10, 8.9% were hospitalized with CVD or died from it.
  • In women with scores of 11 to 100, the percentage was 13.5%.
  • In women with scores of 101 to 400, the figure was 17.5%.
  • In women with scores over 400, 28.3% were hospitalized with CVD or died from it.
  • After adjusting for age and year of diagnosis, women with the highest CAC scores were 3.7 times more likely to be diagnosed with CVD than women with a CAC of 0.

In women treated with the chemotherapy drug anthracycline along with radiation, the link between a high CAC score and CVD was even stronger.  

Conclusion: The researchers hope that their findings will provide a simple method to determine early risk factors for heart disease in breast cancer patients. Prevention strategies include close monitoring with a cardiologist and lifestyle changes, such as adopting a heart-healthy diet, losing weight and exercising.

Source: Division of Imaging and Oncology at University Medical Center Utrecht, The Netherlands, research presented at the 12th European Breast Cancer Conference.