Outcome for breast cancer patients with congestive heart failure after epirubicin treatment

e13635 Background: Approximately 40% of females over the age of 65 are newly diagnosed with breast cancer. When considering elderly patients with breast cancer ( > 65 years old), complex decision making is required as patients have multiple cardiac comorbidities that may confound treatment goals. In this abstract, we aim to identify survival and cardiac outcomes in elderly individuals. Methods: This study was conducted using a retrospective cohort design with use electronic patient records. ICD diagnoses codes were used to identify breast cancer patients. Our initial search criteria revealed 1618 patients. Our eligibility criteria included adult patients 18 years and older with newly diagnosed breast cancer from January 1st, 2014 – January 31st, 2017 which yielded 478 patients. All data was collected through retrospective chart review. Analysis was performed with SAS v9.4 software. Qualitative variables were analyzed using Chi-Square Test. Survival curves are estimated using Kaplan-Meier methodology and analyzed with a log rank test. Predictors of survival are assessed with Cox proportional hazards regression analyses. All significance was assumed at the p < 0.05 level and reported as hazard ratios (HR). Results: Of our 478 breast cancer patients, 260 (59.5%) patients were less than age 65 and 177 (40.5%) patients were older than age 65. Of these two age groups, cardiac events including new diagnosis of heart failure (HF), heart failure (HF) hospitalization, and acute coronary syndrome were studied. For patients with age less than 65: n = 11 for new diagnoses of HF, n = 4 for HF hospitalizations, and n = 3 for ACS. For patients with age greater than 65: n = 5 for new diagnoses of HF, n = 3 for HF hospitalizations, and n = 2 for ACS. Comparing these two groups, there was no statistically significant cardiac event (p = > 0.05). Comparing survival among these two age groups also did not yield statistically significant results (p > 0.05). Conclusions: Per our data, it appears that there is no statistically significant difference in cardiac outcomes in different age groups for patients with breast cancer. Additionally, there was no difference in mortality among different age groups with breast cancer patients. Further prospective studies should be performed to confirm trends of mortality.

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Congestive Heart Failure in Older Women Treated With Adjuvant Anthracycline Chemotherapy for Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.10.4976 ◽

2007 ◽

Vol 25 (25) ◽

pp. 3808-3815 ◽

Cited By ~ 377

Author(s):

Mary C. Pinder ◽

Zhigang Duan ◽

James S. Goodwin ◽

Gabriel N. Hortobagyi ◽

Sharon H. Giordano

Keyword(s):

Breast Cancer ◽

Heart Failure ◽

Congestive Heart Failure ◽

Cox Regression ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

The Difference ◽

Artery Disease ◽

Medicare Database ◽

Anthracycline Chemotherapy

Purpose Limited data are available on long-term cardiac safety of adjuvant anthracycline chemotherapy in breast cancer patients over age 65 years. We evaluated rates and predictors of congestive heart failure (CHF) in this population. Patients and Methods We used the Surveillance, Epidemiology, and End Results Medicare database and included women with no history of CHF who were age 66 to 80 years and diagnosed with stage I to III breast cancer from 1992 to 2002. Cumulative rates of CHF were estimated, and multivariable Cox regression analysis was used to determine factors associated with the development of CHF. Results A total of 43,338 women were included. Anthracycline-treated women were younger, with fewer comorbidities and more advanced disease than women who received nonanthracycline or no chemotherapy (P < .001 for each). The adjusted hazard ratio (HR) for CHF was 1.26 (95% CI, 1.12 to 1.42) for women aged 66 to 70 treated with anthracycline compared with other chemotherapy. For women aged 71 to 80, adjuvant chemotherapy type was not associated with CHF. The following baseline characteristics were significant predictors of CHF: age (HR, 1.79 per 10 years; 95% CI, 1.66 to 1.93), black race (HR, 1.40; 95% CI, 1.30 to 1.50), trastuzumab treatment (HR, 1.46; 95% CI, 1.21 to 1.77), hypertension (HR, 1.45; 95% CI, 1.39 to 1.52), diabetes (HR, 1.74; 95% CI, 1.66 to 1.83), and coronary artery disease (HR, 1.58; 95% CI, 1.39 to 1.79). Left-sided radiotherapy did not confer an elevated risk of CHF (HR, 1.04; 95% CI, 0.98 to 1.11). Conclusion Women aged 66 to 70 years who received adjuvant anthracyclines had significantly higher rates of CHF. The difference in rates of CHF continued to increase through more than 10 years of follow-up.

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