Relationship of breast arterial calcification and radiotherapy

Year 2024, Volume: 10 Issue: 3, 268 - 275, 04.05.2024

Gökhan Karataş , Osman Kula , Nermin Tunçbilek

https://doi.org/10.18621/eurj.1382545

Abstract

Objective: The purpose of this research is to compare the pre and post-radiotherapy mammograms of patients who had breast-conserving surgery (BCS) and radiotherapy to see how radiotherapy affects breast arterial calcifications (BAC).

Methods: The study retrospectively compared the mammography examinations at least 24 months after radiotherapy and pre-radiotherapy mammography examinations of 123 female patients diagnosed with breast cancer and treated with BCS and radiotherapy between December 2001 and July 2011.

Results: Breast arterial calcifications (BAC) increased statistically significantly in 25 patients who underwent radiotherapy after BCS.

Conclusion: Our results indicate that BAC increases significantly after RT, especially in breasts treated with radiotherapy, with age being also a risk factor for BAC development.

Keywords

Breast arterial calcification, radiotherapy, mammography

References

• 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: 10.3322/caac.21492.
• 2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34. doi: 10.3322/caac.21551.
• 3. Breast Cancer. National Comprehensive Cancer Network: National Clinical Practice Guidelines in Oncology. Version 3. 2018. https://www.nccn.org/ professionals/physician_gls/pdf/breast.pdf
• 4. Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med. 2002;347(8):567-575. doi: 10.1056/NEJMoa020128.
• 5. Early Breast Cancer Trialists' Collaborative Group (EBCTCG); Darby S, McGale P, Correa C, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707-1716. doi: 10.1016/S0140-6736(11)61629-2.
• 6. EBCTCG (Early Breast Cancer Trialists' Collaborative Group); McGale P, Taylor C, Correa C, et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 2014;383(9935):2127-2135. doi: 10.1016/S0140-6736(14)60488-8.
• 7. Grantzau T, Overgaard J. Risk of second non-breast cancer among patients treated with and without postoperative radiotherapy for primary breast cancer: a systematic review and meta-analysis of population-based studies including 522,739 patients. Radiother Oncol. 2016;121(3):402-413. doi: 10.1016/j.radonc.2016.08.017.
• 8. Boero IJ, Paravati AJ, Triplett DP, et al. Modern radiation therapy and cardiac outcomes in breast cancer. Int J Radiat Oncol Biol Phys. 2016;94(4):700-708. doi: 10.1016/j.ijrobp.2015.12.018.
• 9. Hendriks EJ, de Jong PA, van der Graaf Y, Mali WP, van der Schouw YT, Beulens JW. Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events. Atherosclerosis. 2015;239(1):11-20. doi: 10.1016/j.atherosclerosis.2014.12.035.
• 10. Duhn V, D'Orsi ET, Johnson S, D'Orsi CJ, Adams AL, O'Neill WC. Breast arterial calcification: a marker of medial vascular calcification in chronic kidney disease. Clin J Am Soc Nephrol. 2011;6(2):377-382. doi: 10.2215/CJN.07190810.
• 11. Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension. 2001;38(4):938-942. doi: 10.1161/hy1001.096358.
• 12. Rotter MA, Schnatz PF, Currier AA Jr, O'Sullivan DM. Breast arterial calcifications (BACs) found on screening mammography and their association with cardiovascular disease. Menopause. 2008;15(2):276-281. doi: 10.1097/gme.0b013e3181405d0a.
• 13. Topal U, Kaderli A, Topal NB, et al. Relationship between the arterial calcification detected in mammography and coronary artery disease. Eur J Radiol. 2007;63(3):391-395. doi: 10.1016/j.ejrad.2007.01.035.
• 14. Chadashvili T, Litmanovich D, Hall F, Slanetz PJ. Do breast arterial calcifications on mammography predict elevated risk of coronary artery disease? Eur J Radiol. 2016;85(6):1121-1124. doi: 10.1016/j.ejrad.2016.03.006.
• 15. Soran O, Vargo JA, Polat AV, Soran A, Sumkin J, Beriwal S. No association between left-breast radiation therapy or breast arterial calcification and long-term cardiac events in patients with breast cancer. J Womens Health (Larchmt). 2014;23(12):1005-1011. doi: 10.1089/jwh.2014.4748.
• 16. Maas AH, van der Schouw YT, Mali WP, van der Graaf Y. Prevalence and determinants of breast arterial calcium in women at high risk of cardiovascular disease. Am J Cardiol. 2004;94(5):655-659. doi: 10.1016/j.amjcard.2004.05.036.
• 17. Cihan YB. Can radiotherapy for breast cancer increase breast arterial calcification? Natl Med J India. 2019;32(3):190. doi: 10.4103/0970-258X.278680.
• 18. GOLD H. Production of arteriosclerosis in the rat. Effect of x-ray and a high-fat diet. Arch Pathol. 1961;71:268-273.
• 19 Aarnoudse MW, Lamberts HB. Arterial wall damage by X-rays and fast neutrons. Int J Radiat Biol Relat Stud Phys Chem Med. 1977;31(1):87-94. doi: 10.1080/09553007714550081.
• 20. Marcial-Rojas RA, Castro JR. Irradiation injury to elastic arteries in the course of treatment for neoplastic disease. Ann Otol Rhinol Laryngol. 1962;71:945-958. doi: 10.1177/000348946207100408.
• 21. Roos CTG, van den Bogaard VAB, Greuter MJW, et al. Is the coronary artery calcium score associated with acute coronary events in breast cancer patients treated with radiotherapy? Radiother Oncol. 2018;126(1):170-176. doi: 10.1016/j.radonc.2017.10.009.
• 22. James M, Swadi S, Yi M, Johansson L, Robinson B, Dixit A. Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series. J Med Imaging Radiat Oncol. 2018;62(3):425-431. doi: 10.1111/1754-9485.12712.
• 23 Osman M, Regner S, Osman K, et al. Association between breast arterial calcification on mammography and coronary artery disease: a systematic review and meta-analysis. J Womens Health (Larchmt). 2022;31(12):1719-1726. doi: 10.1089/jwh.2020.8733.
• 24. Jiang X, Clark M, Singh RK, Juhn A, Schnatz PF. Association of breast arterial calcification with stroke and angiographically proven coronary artery disease: a meta-analysis. Menopause. 2015;22(2):136-143. doi: 10.1097/GME.0000000000000300.
• 25. Shah N, Chainani V, Delafontaine P, Abdo A, Lafferty J, Abi Rafeh N. Mammographically detectable breast arterial calcification and atherosclerosis. Cardiol Rev. 2014;22(2):69-78. doi: 10.1097/CRD.0b013e318295e029.