Is there an increased risk of local recurrence under the heart block in patients with left-sided breast cancer?

Journal Article (Journal Article)

UNLABELLED: Tangential radiotherapy for left-sided breast cancer may be cardiotoxic. Shaping the field with a heart block reduces cardiac exposure but may under-dose the breast and/or chest wall. We compared the incidence and location of local recurrences in patients irradiated with and without a heart block. METHODS AND MATERIALS: Between 1994 and 1998, 180 patients irradiated to the left breast and/or chest wall were retrospectively reviewed. The local recurrence rates in patients treated with and without a heart block were compared using a 2-tailed Fisher exact test. An in-depth dosimetric analysis was performed in 23 patients to assess the percentage of breast tissue under-dosed by inclusion of the heart block. RESULTS: Overall, the local recurrence rates in patients with or without a heart block were similar. In postlumpectomy patients with inferiorly located tumors, the rates of local recurrence with and without a heart block were 2 of 6 patients versus 0 of 19 patients, respectively. In the dosimetric analysis, the average percentage of breast tissue under-dosed by the inclusion of a heart block was 2.8% (range, 0%-11%). DISCUSSION: A heart block is a reasonable method to limit cardiac dose but should be used cautiously following a lumpectomy in patients with inferiorly located tumors. Additional study with larger numbers of patients is warranted.

Full Text

Duke Authors

Cited Authors

  • Raj, KA; Evans, ES; Prosnitz, RG; Quaranta, BP; Hardenbergh, PH; Hollis, DR; Light, KL; Marks, LB

Published Date

  • 2006

Published In

Volume / Issue

  • 12 / 4

Start / End Page

  • 309 - 317

PubMed ID

  • 16925976

International Standard Serial Number (ISSN)

  • 1528-9117

Digital Object Identifier (DOI)

  • 10.1097/00130404-200607000-00010


  • eng

Conference Location

  • United States