Original Investigation

Laterality of Breast Radiotherapy and Ischemic Heart Disease by Cardiovascular Risk Burden

JAMA Network Open 10.1001/jamanetworkopen.2026.31356

September 02, 2026 at 11:00 AM EDT

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In this cohort study of 23 305 women with breast cancer, excess cardiac risk associated with left-sided RT was concentrated among patients with 3 cardiovascular risk factors. These findings suggest that among patients with low baseline risk profiles, the difference in IHD risk between left- and right-sided treatment may be small, whereas those with high cardiovascular burden warrant prioritized access to advanced heart-sparing modalities and aggressive risk factor management.

Corresponding Author: O Kyu Noh, MD, PhD, Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Republic of Korea (okyu.noh@gmail.com).

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