Radiation induced myocardial perfusion abnormalities in patients with left breast cancer: A prospective study with short and long term follow up

Authors

  • Alireza Emami-Ardekani Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Armaghan Fard-Esfahani Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Arman Hasanzadeh-Rad Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Babak Fallahi Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Davood Beiki Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Elham Kalantari Department of Internal medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  • Forough Kalantari Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Hamidreza Amini Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mehrshad Abbasi Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammad Eftekhari Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Saeed Farzanefar Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract:

Introduction:The external beam radiation therapy for patients with left breast cancer at the mastectomy site may cause myocardial perfusion abnormalities. We intended to study the change of these abnormalities at short and long term post radiotherapy follow up. Methods: Twenty patients with left and 20 patients with right breast cancer comprised the exposed and control groups, respectively. The patients had low risk for coronary disease. They underwent myocardial perfusion scans (MPS) 3 years after the external beam radiation therapy at the bed of modified radical mastectomy. These subjects were recruited from two bigger cohorts with previously reported data of scans at 6 months. The scans were acquired after injections of about 20 mCi MIBI at peak pharmacologic stress and at rest. The change of the perfusion abnormalities by both visual assessment and quantifications (Autoquant) at the baseline and 3 years follow up time are compared between exposed and control patients. Results: The exposed patients had more visual perfusion abnormality scores compared to control subjects (1.1±1.3 vs. 0.3±1.0; p=0.03). The indices of perfusion abnormality normalized in control subjects from baseline to follow up scans (p= 0.05 for summed difference score and p=0.04 for summed stress score). The difference of the perfusion abnormalities between the exposed and unexposed subjects remained unchanged along the 3 years of follow up. Conclusion: The radiation induced myocardial perfusion abnormalities in patients with left breast cancer could cause permanent coronary disease over time.

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Journal title

volume 25  issue Supplement 1

pages  21- 25

publication date 2017-02-01

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