In Reply to Struikmans et al.

We thank Struikmans et al for their interest in our consensus statement.1 We are in agreement, as highlighted in multiple locations of our manuscript, that “advances have been made in photon cardiac sparing with techniques such as deep-inspiratory breath hold,” which may reduce the absolute risk of breast cancer radiation therapy in the modern era.2 In addition, improvements in cardiologic medicine are likely to lower the risk of cardiovascular events, including death, in those burdened with radiation-associated coronary disease in the years ahead.