With advances in diagnosis and treatment, breast cancer has become an increasingly
survivable disease with a growing population of long-term survivors. As an essential
component of breast conservation therapy, radiotherapy is a standard treatment for
many women with stage I/II breast cancer. Cardiac radiation exposure has been associated
with an increased risk of cardiovascular diseases. Among these are coronary artery disease,
cardiomyopathy, valvular heart disease, and pericardial disease. Microvascular changes
and accelerated atherosclerosis are likely the primary underlying mechanisms of radiation
induced cardiovascular damage. A simple and highly effective technique, deep inspiration
breath-hold (DIBH), has been shown to decrease cardiac radiation exposure without compromising
target coverage. This brief review focuses on the effects of radiation therapy on
the heart, radiation-induced cardiovascular diseases in breast cancer survivors, and the
DIBH technique as a means for reducing cardiac radiation exposure.
Keywords: Breast cancer, cardiotoxicity, cardiovascular diseases, DIBH, fibrosis, radiotherapy.
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