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This study assessed the impact of adjuvant RT on heart-related deaths in patients with ductal carcinoma in situ. Patients who underwent adjuvant RT after breast-conserving surgery between 1988 and 2008 were identified from the Surveillance, Epidemiology, and End Results database. Kaplan\u2012Meier and competing risks analyses were conducted after propensity score-matching according to tumor laterality. A total of 41,526 propensity-matched patients were identified (n\u2009=\u200920,763 for either left- or right-sided tumor). In the analysis of the cumulative incidence of heart-related mortality events, there was a greater risk increment in the left-sided group over the first to second decades after RT in patients aged\u2009\u2264\u200950\u00a0years (<jats:italic>P<\/jats:italic>\u2009=\u20090.048). Competing risks analysis of the young patients showed that left-sided RT was associated with higher heart-related mortality rates (Grey\u2019s test, <jats:italic>P<\/jats:italic>\u2009=\u20090.049). The statistical significance remained after adjusting for other covariates (subdistribution hazard ratio 2.35; 95% confidence interval 1.09\u20125.10). Regarding the intrinsic effect of modern RT techniques, further strategies to reduce heart-related risks are needed for young patients. Close surveillance within an earlier follow-up period should be considered for these patients in clinics.<\/jats:p>","DOI":"10.1038\/s41598-021-82263-8","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T13:21:09Z","timestamp":1612272069000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Heart-related mortality after postoperative breast irradiation in patients with ductal carcinoma in situ in the contemporary radiotherapy era"],"prefix":"10.1038","volume":"11","author":[{"given":"Yu Jin","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaemoon","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"82263_CR1","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1093\/jnci\/dji067","volume":"97","author":"SH Giordano","year":"2005","unstructured":"Giordano, S. 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