{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:01:17Z","timestamp":1776060077078,"version":"3.50.1"},"reference-count":30,"publisher":"Korean Cancer Association","issue":"2","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100002476","name":"Eulji University","doi-asserted-by":"publisher","award":["2024-0094"],"award-info":[{"award-number":["2024-0094"]}],"id":[{"id":"10.13039\/501100002476","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-crt.org"],"crossmark-restriction":true},"short-container-title":["Cancer Res Treat"],"published-print":{"date-parts":[[2026,4,15]]},"abstract":"<jats:p>PurposeThis 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 &lt; 0.001). On the other hand, HR (95% CI) for mortality from non-CAD causes was 3.57 (3.48-3.67, p &lt; 0.001).ConclusionIn 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.<\/jats:p>","DOI":"10.4143\/crt.2025.233","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T22:15:49Z","timestamp":1749593749000},"page":"534-543","update-policy":"https:\/\/doi.org\/10.4143\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiation-Associated Heart Disease in Korean Women after Radiotherapy for Breast Cancer: Insights from the National Health Insurance Service Database"],"prefix":"10.4143","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1007-1633","authenticated-orcid":true,"given":"Jun-Hyuk","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimin","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5205-3775","authenticated-orcid":true,"given":"Tae Hyung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2954","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1209825"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2016.72.0722"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.08.048"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2015.06.007"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2024.102594"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.128"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2018.11.003"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4398-y"},{"key":"ref9","volume-title":"","year":"2025"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2019.01.003"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s42444-019-0005-0"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2020.0171"},{"key":"ref13","first-page":"S20","volume-title":"2. 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