Introduction

Modern adjuvant treatments for early-stage breast cancer have improved survival rates, shifting clinical focus towards managing long-term effects such as radiation-induced cardiovascular disease (CVD). This study aimed to evaluate and explore, amongst breast cancer patients treated with non-palliative radiotherapy, their awareness, understanding, risk perceptions and health beliefs around CVD & cardiovascular late effects of radiotherapy.

Methods

Purposeful sampling was used to recruit participants with lived experience of early breast cancer, to explore their perceptions and understanding of the risks of cardiovascular late effects following adjuvant left-sided radiotherapy. University ethical approval was obtained. Participants were recruited for interview through Breast Cancer Now. Each interview was audio-recorded, transcribed verbatim and thematically analysed.

Results

Ten semi-structured interviews were completed with participants aged between 42 and 56, across three UK nations. Analysis established four themes: Knowledge and perception of risk, Heart-health follow-up, Heart-healthy behaviours and Needs and preferences. Participants were indirectly aware of CVD risks via discussions on heart volume mitigation techniques by their radiotherapy healthcare professionals, but direct information on the risks, as well as health promotion conversations were lacking.

Conclusion

Despite receiving complex radiotherapy with known cardiac implications, women often feel under-informed about long-term cardiovascular risks. The provision of timely information can support the process of informed consent and support patients to be active in their own self-management and care, helping to mitigate long term CVD risk.

Implications for practice

To improve outcomes, radiotherapy teams must deliver timely, clear, and personalised information, supported by standardised tools. Our findings support calls for national survivorship protocols to include cardiovascular monitoring for high-risk breast cancer survivors.