Abstract
Background: Locoregional management in breast cancer patients includes surgery and radiation. Radiation increases the risk of the decreasing of cardiac ventricular performance and known as cardiotoxicity. This study aims to analyze the relationship between radiation exposure in locally advanced breast cancer patients with the left ventricular systolic function. Methods: The subjects in this study were patients with locally advanced breast cancer who underwent external radiation therapy after surgery procedure at Dr. Soetomo General Hospital in January 2021 – April 2021. Examination of left ventricular performance parameters was carried out using an invasive method, the transthoracic echocardiography. The performance parameters examined were left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Results: A total of 45 patients were recruited in this study. Twenty-two patients (22/45; 48.9%) underwent radiation therapy from the left side and 23 patients (23/45; 51.1%) from the right side. After external radiation, the number of patients with left ventricular dilatation were increased. On the left side, there were 6 patients (6/22; 27.6%) who experienced dilatation compared to before radiation (3 patients), while on the right side of the body there were 8 patients (8/22; 34.8%) who experienced dilatation compared to before radiation (6 patients). There was an increase in the number of patients who experienced a decrease in EFT and EFB after radiation, although the association was not significant. Almost all patients experienced a decrease in GLS values after radiation (44/45; 97.8%). Conclusion: There was an increase in the number of patients with left ventricular dilatation and decrease in EFT and EFB values after external radiation. Decreased GLS values were found in almost all patients who underwent external radiation in this study. Keywords: Radiation, locally advanced breast cancer, LVID, ejection fraction, GLS.
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