Conflict of interest Orfit Industries Wijnegem Belgium

The risk of long-term cardiac injury from whole breast radiotherapy for early-stage breast cancer after breast-conserving surgery remains a topical issue [1]. The Early Breast Cancer Trialists’ Collaborative Group studied the long-term side-effects of radiotherapy and found an increased risk of mortality from AMG-208 disease among patients receiving radiotherapy [2]. Older studies have suggested that left-sided breast radiotherapy is associated with greater mortality from cardiac causes compared to right-sided radiotherapy [3] and [4]. However, newer studies using population-based data concluded that there was no difference in mortality due to ischemic heart disease or other cardiac causes among women treated for left or right-sided breast cancer with conventional fractionated whole breast radiotherapy (CF-WBI) [5]. Population-based data using Surveillance, Epidemiology and End-Results (SEER)-Medicare also found no difference in mortality with left vs. right-sided cases in women treated after 1982 [6].