Association between radiotherapy laterality and cardiovascular disease mortality in male breast cancer patients receiving postoperative radiotherapy: a competing risks analysis and standardized mortality ratio assessment using SEER data.
- 1Department of Electrocardiographic and Cardiac Examination, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, China.
- 2Department of Radiotherapy, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, China.
- 3Department of Radiotherapy, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, China.
Abstract
Background
The association between radiotherapy (RT) laterality and cardiovascular disease (CVD) mortality in male breast cancer (MBC) remains unknown. We evaluated whether left-sided RT confers higher CVD mortality than right-sided RT in MBC patients, and quantified excess CVD mortality relative to the general U.S. male population.Methods
This retrospective cohort study included 2,152 MBC patients receiving postoperative RT from the SEER database (2000-2020). Fine-Gray competing risks regression estimated subdistribution hazard ratios (sHRs) for CVD death comparing left- vs. right-sided RT. Multiple sensitivity analyses were performed, including propensity score matching (PSM). Standardized mortality ratios (SMRs) were calculated using age-specific CVD mortality rates from CDC WONDER.Results
Over a median follow-up of 5.6 years, no significant difference in CVD mortality was observed between left- and right-sided RT (fully adjusted sHR = 1.03; 95% CI: 0.71-1.49; P = 0.887). Results remained consistent across all sensitivity analyses (all P > 0.750). Compared with the general U.S. male population, irradiated MBC patients had a significantly elevated risk of CVD death (SMR = 1.36; 95% CI: 1.15-1.61). Age-stratified analysis showed the numerically highest point estimate in the 45-54 age group (SMR = 2.08; 95% CI: 0.84-4.29), though this did not reach statistical significance.Conclusions
In MBC patients receiving modern RT, left- and right-sided treatment confer comparable risks of CVD mortality. Nevertheless, overall CVD mortality remains significantly higher than in the general U.S. male population, warranting comprehensive cardiovascular risk assessment and management for all RT recipients.
Related
- Investigating the association between osteoarthritis and cardiovascular disease using a standardized cardiovascular health assessment tool in a nationwide health survey
- Association of Hemispheric Laterality with Neurosurgical Intervention in Intracerebral Hemorrhage: A Post-Hoc Bayesian Analysis of ATACH-2 and ERICH
- A standardized patient-derived glioblastoma organoid platform for evaluating radiotherapy efficacy and overcoming resistance
- Safety of concurrent immune checkpoint inhibitor therapy during postoperative radiotherapy for triple-negative breast cancer: A preliminary retrospective analysis
- Postoperative radiotherapy after tracheal reconstruction with cryopreserved aortic allograft for adenoid cystic carcinoma
BibTeX
@article{si2026association,
title = {{Association between radiotherapy laterality and cardiovascular disease mortality in male breast cancer patients receiving postoperative radiotherapy: a competing risks analysis and standardized mortality ratio assessment using SEER data.}},
author = {Jia Si and YuFeng Zhang and Jianfei Jin and Fang Su},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1857560},
url = {https://europepmc.org/article/MED/42908767},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between radiotherapy laterality and cardiovascular disease mortality in male breast cancer patients receiving postoperative radiotherapy: a competing risks analysis and standardized mortality ratio assessment using SEER data.
AU - Jia Si
AU - YuFeng Zhang
AU - Jianfei Jin
AU - Fang Su
PY - 2026
DA - 2026/10/07
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1857560
UR - https://europepmc.org/article/MED/42908767
AB - Background The association between radiotherapy (RT) laterality and cardiovascular disease (CVD) mortality in male breast cancer (MBC) remains unknown. We evaluated whether left-sided RT confers higher CVD mortality than right-sided RT in MBC patients, and quantified excess CVD mortality relative to the general U.S. male population.Methods This retrospective cohort study included 2,152 MBC patients receiving postoperative RT from the SEER database (2000-2020). Fine-Gray competing risks regression estimated subdistribution hazard ratios (sHRs) for CVD death comparing left- vs. right-sided RT. Multiple sensitivity analyses were performed, including propensity score matching (PSM). Standardized mortality ratios (SMRs) were calculated using age-specific CVD mortality rates from CDC WONDER.Results Over a median follow-up of 5.6 years, no significant difference in CVD mortality was observed between left- and right-sided RT (fully adjusted sHR = 1.03; 95% CI: 0.71-1.49; P = 0.887). Results remained consistent across all sensitivity analyses (all P > 0.750). Compared with the general U.S. male population, irradiated MBC patients had a significantly elevated risk of CVD death (SMR = 1.36; 95% CI: 1.15-1.61). Age-stratified analysis showed the numerically highest point estimate in the 45-54 age group (SMR = 2.08; 95% CI: 0.84-4.29), though this did not reach statistical significance.Conclusions In MBC patients receiving modern RT, left- and right-sided treatment confer comparable risks of CVD mortality. Nevertheless, overall CVD mortality remains significantly higher than in the general U.S. male population, warranting comprehensive cardiovascular risk assessment and management for all RT recipients.
SN - 2297-055X
ER -