ABCDE steps to prevent heart disease in breast cancer survivors.

B reast cancer is the most common invasive cancer diagnosed in women. Of every 8 women, 1 woman is diagnosed with breast cancer in her lifetime. In 2013, more than 230 000 women were diagnosed with breast cancer in the United States alone, resulting in nearly 40 000 deaths. Breast cancer can also occur in men, although the incidence is much lower, with a total of 2240 men diagnosed in 2013 (accounting for less than 1% of all breast cancers). Over the past 2 decades, death resulting from breast cancer has been declining each year. This decrease in mortality is due in part to improvements in cancer treatment. These treatments have come about as a result of collaborations among physicians in various specialties. These physicians include medical oncologists (who give systemic treatments like chemother-apy and hormonal therapy), surgeons (who perform surgery such as mastec-tomy and lumpectomy), and radiation oncologists (who treat patients with radiation therapy). Radiation therapy, in particular, has increasingly become an important part of management of most patients with breast cancer. Radiation therapy has been demonstrated not only to prevent recurrence of cancer in the breast or chest wall area but also to improve long-term survival in women. In addition, radiation therapy allows women to undergo a less radical form of surgery in which the breast tissue is conserved, thus improving body image for breast cancer survivors without compromising survival. As a result of this progress in treatment and improved detection of early breast cancer, in 2012, there were nearly 3 million breast cancer survivors in the United States alone, a number that will increase in the coming years. Women who survive breast cancer may face many health challenges, but the number 1 cause of death in breast cancer survivors (and, in fact, all women) remains heart disease. Unfortunately, although systemic therapies and radiation have led to increased survival in many women with breast cancer, they may also increase the risk of subsequent heart problems. In the vast majority of patients, the benefits of these treatments substantially outweigh this risk. This Cardiology Patient Page updates the risk of heart disease in breast cancer survivors, particularly those who received radiation as part of their treatment. We highlight important steps that breast cancer survivors can take to decrease their risk of subsequent heart disease. In cardio-oncology clinics, we have adapted specific ABCDE steps that are effective in preventing heart disease …