Analysis of clinical characteristics of breast cancer survivors who received breast radiotherapy and diagnosed with coronary heart disease

Objective To compare the clinical characteristics of female breast cancer survivors compared with ordinary women at the first diagnosis of coronary heart disease.

Methods Totally, 80 female breast cancer survivors diagnosed by coronary angiography at the Department of Cardiology, Affiliated Hospital of Xuzhou Medical University from January 2013 to December 2019 were included in the breast cancer and coronary heart disease group, and 313 female non-breast cancer patients diagnosed with coronary heart disease by coronary angiography from January to December 2019 were included in the non-breast cancer and coronary heart disease group. The risk factors, coronary angiography results, and Gensini scores of each group were retrospectively analyzed.

Results The proportion of the middle and distal left anterior descending artery and the proximal right coronary artery in the breast cancer coronary heart disease group with a history of radiotherapy and Gensini score was significantly higher than that in the non-breast cancer coronary heart disease group, and the differences were statistically significant (P < 0.05). In patients with breast cancer and coronary heart disease, logistic regression analysis showed that type 2 diabetes (OR=4.245, 95%CI 1.087-16.576) and radiotherapy history (OR=2.870, 95%CI 1.027-8.021) were the risk factors for high Gensini score in this group.

Conclusions The severity of coronary heart disease in female breast cancer survivors was higher than that of the general female population, in addition, patients with a history of radiotherapy on the left side of the breast were more prone to the damage in the middle and distal ends of the left anterior descending branch, Patients with a history of radiotherapy to the right breast are more prone to the damage in the proximal right coronary artery. Among female breast cancer survivors who have newly developed coronary heart disease, patients with type 2 diabetes and patients with a history of breast radiation therapy were also more likely to have severe coronary artery stenosis.