Are Breast Cancer Survivors at Increased Risk for Cardiovascular Diseases?
Posted: Monday, April 12, 2021
Cardiovascular risks are increased in breast cancer survivors, although very few studies have quantified cardiac outcomes in detail. Jennifer L. Lund, PhD, of the University of North Carolina at Chapel Hill, and colleagues conducted a matched cohort study to examine the prevalence of clinically specific cardiovascular outcomes at breast cancer diagnosis and after diagnosis among cancer survivors. Their findings revealed that women with a history of breast cancer were at increased risk of several cardiovascular diseases—including deep vein thrombosis, pericarditis, cardiac arrest, arrhythmia, heart failure, and valvular heart disease—persisting into survivorship. These findings were published in the Journal of the National Comprehensive Cancer Network.
“Monitoring and managing cardiovascular risk throughout the long-term follow-up of women diagnosed with breast cancer should be a priority,” concluded the investigators.
Data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare–linked claims-based database were used in this study. Women aged 65 years and older with breast cancer incidence from 2004 to 2013 were matched with five cancer-free female counterparts (5:1 ratio). This resulted in 545,670 women, with 91,473 (17%) having breast cancer and 454,197 (83%) who did not. The prevalence of cardiovascular outcomes was measured at baseline, and then Cox regression was used to calculate hazard ratios for cardiovascular risk during follow-up.
Findings revealed that compared with controls, breast cancer survivors had substantially increased risks of deep vein thrombosis (adjusted hazard ratio = 1.67; 95% confidence interval [CI] = 1.62–1.73; 386,484 person-years of follow-up) and pericarditis (hazard ratio = 1.43; 95% CI = 1.38–1.49; 390,776 person-years of follow-up). Additionally, there was evidence of smaller increased risks of sudden cardiac arrest, arrhythmia, heart failure, and valvular heart disease (adjusted hazard ratios ranging from 1.05–1.09, lower CI limits all ≥ 1). They also found increased arrhythmia risks, heart failure, pericarditis, and deep vein thrombosis persisting more than 5 years after diagnosis.
Disclosure: For full disclosure of the study authors, visit jnccn.org.