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Radiation-Associated Heart Disease in Korean Women after Radiotherapy for Breast Cancer: Insights from the National Health Insurance Service Database

Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: This study investigated the risk of radiation-associated heart disease (RAHD) in Korean women treated with radiotherapy (RT) for breast cancer (BC) using data from the National Health Insurance Service database. MATERIALS AND METHODS: A retrospective cohort analysis was conducted on 65,188 patients with BC treated with RT between 2009 and 2014 and 325,940 controls without BC or prior coronary artery disease (CAD), with 1:5 exact matching by age, type 2 diabetes mellitus, hypertension, and dyslipidemia status. CAD encompassed both incident events and fatal events. Competing risk analysis was conducted to estimate subdistribution hazard ratio (HR) with 95% confidence interval (CI) for CAD, setting mortality from non-CAD causes as a competing risk. RESULTS: During the mean 9.9 years of follow-up period, 3,852 (1.0%) CAD and 20,999 (5.4%) death from non-CAD causes were reported. Compared to controls, participants with BC who received RT had a significantly lower risk of CAD incidence. HR (95% CI) for CAD in the BC with RT group was 0.66 (0.60-0.73, p < 0.001). On the other hand, HR (95% CI) for mortality from non-CAD causes was 3.57 (3.48-3.67, p < 0.001). CONCLUSION: In this large population-based cohort study, breast cancer patients who received RT did not show an increased incidence of CAD compared with the general population without breast cancer. Individual-level dosimetric data and longer follow-up are needed to clarify the independent risk.
DOI: 10.4143/crt.2025.233
Authors: Jun-Hyuk Lee, Jimin Park, Tae Hyung Kim
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W4411164913
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