Risk of heart disease in breast cancer patients can be predi
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Automated analysis of breast cancer patients' routine scans can predict which women have a greater than one in four risk of going on to develop cardiovascular disease, according to research presented at the 12th European Breast Cancer Conference.

The study included around 14,000 breast cancer patient who were treated with radiotherapy in three large hospitals in The Netherlands between 2005 and 2016.

Researchers used a measure called coronary artery calcium (CAC) score. This is a calculation of the amount of calcium in the walls of the heart's arteries and it is known to be strong risk factor in cardiovascular disease because calcifications can lead to narrowing or blocking of the blood vessels.

The researchers developed a deep learning algorithm that could gauge the presence and extent of coronary artery calcifications from the CT scans that were already being carried out to help plan each woman's radiotherapy treatment. This allowed them to automate the measurement of CAC for all the women with only minimal extra workload.

Researchers followed the women for an average of 52 months to see whether any of them developed cardiovascular disease. In women with no calcifications (a score of zero), 5% went on to be hospitalized or to die from cardiovascular disease. In women with a score of between one and ten, 8.9% were hospitalized with or died from cardiovascular disease. In women with a score of 11-100, the figure was 13.5%, in women with a score of 101-400 it was 17.5% and in women with a score above 400, it was 28.3%.

When researchers took into account women's ages and the year they were diagnosed, they found a 3.7 times greater risk of cardiovascular disease in women with the highest score (above 400), compared with women with no calcifications. In women who were treated with a particular type of chemotherapy called an anthracycline, the association between high CAC score and cardiovascular risk was even stronger.

The researchers acknowledge that they were unable to take other cardiovascular disease risk factors, such as smoking, high blood pressure and diabetes, into account in this study, although these are factors they are looking at in another study.

They said: "We believe this is the first time anyone has conducted a large-scale study like this. We've shown that we can use routine CT scans to indicate which breast cancer patients are most likely to develop cardiovascular disease. Now we need to do more research to find out what can be done to help minimize this risk, for instance whether patients' cardiovascular health should be monitored or treated."

Source: https://cm.eortc.org/cmPortal/Searchable/ebcc-12V/config/searchable#!abstractdetails/0000888640
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