{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T22:23:23Z","timestamp":1769639003066,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FONDECYT","award":["11190071"],"award-info":[{"award-number":["11190071"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Radiotherapy (RT) is an essential part of breast cancer (BC) treatments. Unfortunately, heart exposure to radiation can also impair the long-term survival of patients. Our study aimed to quantify the oncological benefit and the cardiovascular (CV) risk associated with modern RT in a real-world cohort of BC patients. Our descriptive study enrolled BC patients who received adjuvant RT. Ten-year overall survival (OS) was estimated using Predict\u00ae version 2.1 (National Health Service, London, UK). The basal risk of CV events was estimated using the American Heart Association (ACC\/AHA) CV score. Treatment volumes and mean cardiac doses were obtained from RT treatment plan records. The increased risk of CV events due to RT was estimated using a model proposed by Darby. The risk of acute myocardial infarction or stroke mortality was estimated using HeartScore\u00ae (European Society of Cardiology, Brussels, Belgium). A total of 256 BC patients were included in the study. The average age of patients was 57 years old (range: 25\u201391); 49.6% had left BC. The mean cardiac dose was 166 cGy (interquartile range (IQR) 94\u2013273); the estimated hazard ratio (HR) for CV disease was HR 1.12 (confidence interval (CI) 1.04\u20131.24). The estimated baseline 10-year CV risk was 5.6% (0.2 to 51.2); CV risk increased by 0.9% (range 0.02\u201335.47%) after RT. The absolute risk of 10-year mortality from CV disease was 2.5% (0.1\u20139); RT was associated with an estimated 4.9% survival benefit (3.73\u20136.07) against BC death and a 0.23% (0.17\u20130.29) estimated increase in CV mortality. Modern RT decreased 10-year BC mortality by 4% but increased CV mortality by 0.2% in this cohort. Our findings encourage the implementation of personalized adjuvant RT treatments that balance risks and benefits to improve long-term BC patient survival.<\/jats:p>","DOI":"10.3390\/jcm11133889","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T11:15:05Z","timestamp":1656933305000},"page":"3889","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Oncological Benefit versus Cardiovascular Risk in Breast Cancer Patients Treated with Modern Radiotherapy"],"prefix":"10.3390","volume":"11","author":[{"given":"Francisco","family":"Acevedo","sequence":"first","affiliation":[{"name":"Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Ip","sequence":"additional","affiliation":[{"name":"Maule Health Service, Talca Hospital, Talca 3460001, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Orellana","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7120-855X","authenticated-orcid":false,"given":"Gonzalo","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"},{"name":"Advanced Center for Chronic Diseases (ACCDiS), Santiago 8380000, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Gabrielli","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"},{"name":"Advanced Center for Chronic Diseases (ACCDiS), Santiago 8380000, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-5832","authenticated-orcid":false,"given":"Marcelo","family":"Andia","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Marcoleta 377, Santiago 8320000, Chile"},{"name":"Millennium Institute for Intelligent Healthcare & Engineering (ANID), Vicu\u00f1a Mackenna 4860, Macul, Santiago 7820436, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Besa","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Marcoleta 377, Santiago 8320000, Chile"},{"name":"Millennium Institute for Intelligent Healthcare & Engineering (ANID), Vicu\u00f1a Mackenna 4860, Macul, Santiago 7820436, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2484-8033","authenticated-orcid":false,"given":"Mauricio P.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7512-6474","authenticated-orcid":false,"given":"Cesar","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomas","family":"Merino","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8330077, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022, May 19). 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