Risk of Atrial Fibrillation in Breast Cancer Patients Treated with Radiotherapy: A Scoping Review

Abstract

Introduction: Cardiovascular diseases (CVD) are common complications among cancer survivors treated with radiotherapy (RT). Breast cancer (BC) survivors can develop a variety of cardiotoxic complications related to cardiac radiation exposure that occurs months to years after RT, with atrial fibrillation (AF) often reported among them. Purpose: To investigate the potential risk of AF in BC patients treated with RT. Methods: A scoping review was performed in PubMed, CINAHL, Science Direct, Google Scholar and Scopus between 2015-2026 according to Arksey & O’Malley framework following PRISMA for scoping reviews. Articles written in English were retrieved and read in full by two of the authors. This scoping review was limited to individuals >18 years old, with BC treated by RT and diagnosed with AF. Papers focusing on different CVD’s were excluded. Results: A total of 5 studies are included in this scooping review. A relationship between age and AF risk in patients treated with RT was shown. It appears that patients (≥65years) were at higher risk of being diagnosed with AF. A significant increase in the incidence of AF was observed in BC patients undergoing RT compared to those who did not receive RT. Conclusions: The correlation between BC, RT, and AF is a significant source of concern in cancer survivorship treatment. Monitoring of heart implications should be included in long-term follow-up treatment for BC survivors, especially those who received RT. Routine screening for AF and other cardiovascular disorders can assist in the early detection and management of any consequences. Further research into the underlying mechanisms and preventive strategies will be essential to mitigate the cardiovascular risks in BC survivors. Key words: radiotherapy, breast neoplasm, malignancy, tumour, breast cancer, atrial fibrillation, arrhythmias.