Risk of death from cardiovascular disease in long-term breast cancer survivors: A comparison with women from the general population.

Abstract Background There is growing evidence that breast cancer survivors have higher cardiovascular disease (CVD) mortality relative to the general population. Information on temporal patterns for all-cause and CVD mortality among breast cancer survivors relative to cancer-free women is limited. Methods All-cause and CVD-related mortality were compared in 628 women with breast cancer and 3140 age-matched cancer-free women within CLUE II, a prospective cohort. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression for all-cause mortality, and Fine and Gray models for CVD-related mortality to account for competing risks. Results Over 25 years of follow-up, 916 deaths occurred (249 CVD related). Breast cancer survivors had an overall higher risk of dying compared with cancer-free women (HR = 1.79, 95% CI = 1.53 to 2.09) irrespective of time since diagnosis, tumor stage, estrogen receptor status, and older age at diagnosis (≥70 years). Risk of death was greatest among older survivors at more than 15 years after diagnosis (HR = 2.69, 95% CI = 1.59 to 4.55). CVD (69.1% ischemic heart disease) was the leading cause of death among cancer-free women and the second among survivors. Survivors had an increase in CVD-related deaths compared with cancer-free women beginning at 8 years after diagnosis (HR = 1.65, 95% CI = 1.00 to 2.73), with the highest risk among older survivors (HR = 2.24, 95% CI = 1.29 to 3.88) and after estrogen receptor-positive disease (HR = 1.85, 95% CI = 1.06 to 3.20). Conclusions Breast cancer survivors continue to have an elevated mortality compared with the general population for many years after diagnosis. Preventing cardiac deaths, particularly among older breast cancer patients, could lead to reductions in mortality.

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Cardiovascular disease incidence and mortality in breast cancer survivors compared to the general population: Systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.1039 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. 1039-1039 ◽

Cited By ~ 1

Author(s):

Marina Michelle Reeves ◽

Yi Zhong ◽

Jennifer Job ◽

Robert Ware ◽

Brigid Lynch

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cardiovascular Disease ◽

General Population ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Disease Incidence ◽

Meta Analysis ◽

Incidence And Mortality ◽

Cardiovascular Disease Incidence

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Life Expectancy after Curative-intent Treatment of Breast Cancer: Impact on Long-term Follow-up Care

The American Surgeon ◽

10.1177/000313481408000626 ◽

2014 ◽

Vol 80 (6) ◽

pp. 604-609 ◽

Cited By ~ 8

Author(s):

Amanda K. Arrington ◽

Leanne Goldstein ◽

Laura Kruper ◽

Courtney Vito ◽

John Yim ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

General Population ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Survival Curve ◽

Survival Rates ◽

Stage I ◽

Term Survival

Long-term survival rates after treatment for breast cancer are directly influenced by early deaths resulting from disease. For longer-term breast cancer survivors, survival rates appear deceptively low. We hypothesize that the actual survival curve for long-term survivors approaches the overall survival of the general population. The Surveillance, Epidemiology, and End Results database (1988 to 2002) was used to identify patients with nonmetastatic breast cancer who underwent definitive surgical treatment. The survival of the general population was constructed by using national life tables with an age-matched population. Comparisons of survivals were made for 3-, 5-, and 7-year breast cancer survivor cohorts. Of 237,180 patients, 92.4 per cent survived three years, 82.1 per cent five years, and 58.1 per cent seven years. Stage I patients have equivalent or better survivals compared with the age-matched general population in all three cohorts. Stage II patients reached equivalent conditional survival between eight and nine years after diagnosis regardless of cohort. Stage III patients required achieving nine to 10 years after diagnosis to achieve equivalent survival probability, except in 7-year survivors, in whom 10 to 11 years was required. In all stages, once equivalence was reached, survival exceeded the general population over the remaining years. Initial cancer stage influences overall survival for many years after diagnosis. Patients with Stage I cancer return to the general population risk as early as three years after diagnosis, whereas higher stages can require up to nine years to achieve parity with a more generalized population. These findings should be factored into general health screening issues for long-term breast cancer survivors.

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Disparities in Cardiovascular Disease Risk among Hispanic Breast Cancer Survivors in a Population-Based Cohort

JNCI Cancer Spectrum ◽

10.1093/jncics/pkab016 ◽

2021 ◽

Author(s):

Qingqing Hu ◽

Chun-Pin Chang ◽

Kerry Rowe ◽

John Snyder ◽

Vikrant Deshmukh ◽

...

Keyword(s):

Breast Cancer ◽

Cardiovascular Disease ◽

General Population ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Breast Cancer Survivors ◽

Disease Risk ◽

Circulatory System ◽

Cvd Risk ◽

After Cancer

Abstract Background Breast cancer is the leading cause of cancer death among Hispanic women. The aim of our study was to estimate Cardiovascular disease (CVD) risk among Hispanic and non-Hispanic White (NHW) breast cancer survivors compared to their respective general population cohorts. Methods Cohorts of 17,469 breast cancer survivors (1,774 Hispanic and 15,695 NHW) in the Utah Cancer Registry diagnosed 1997–2016, and 65,866 women (6,209 Hispanic and 59,657 NHW) from the general population in the Utah Population Database were identified. Cox Proportional Hazards models were used to estimate hazard ratios (HRs) for CVD. Results The risk of diseases of the circulatory system was higher in Hispanic than NHW breast cancer survivors (HRHispanic =1.94, 99% confidence interval [CI] =1.49–2.53; H NHW =1.38, 99%CI = 1.33–1.43; P heterogeneity=0.01) 1–5 years after cancer diagnosis, in comparison with their respective general population cohorts. Increased risks were observed for both Hispanic and NHW breast cancer survivors for diseases of the heart and the veins and lymphatics, compared to the general population cohorts. More than 5 years after cancer diagnosis, elevated risk of diseases of the veins and lymphatics persisted in both ethnicities. The CVD risk due to chemotherapy and hormone therapy was higher in Hispanic than NHW breast cancer survivors, but did not differ for distant stage, higher baseline comorbidities or baseline smoking. Conclusions We observed a risk difference for diseases of the circulatory system between Hispanic and NHW breast cancer survivors compared to their respective general population cohorts but only within the first 5 years of cancer diagnosis.

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UNTREATED ATHEROSCLEROTIC CARDIOVASCULAR DISEASE RISK IN BREAST CANCER SURVIVORS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)04667-2 ◽

2021 ◽

Vol 77 (18) ◽

pp. 3313

Author(s):

Ravleen Grewal ◽

Amie Jackson ◽

Benjamin Kuritzky ◽

Dominique Brandt ◽

Kamal Shemisa

Keyword(s):

Breast Cancer ◽

Cardiovascular Disease ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Atherosclerotic Cardiovascular Disease ◽

Atherosclerotic Cardiovascular Disease Risk

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Depression als Begleiterkrankung – auch noch Jahre nach der Therapie

Deutsche Zeitschrift für Onkologie ◽

10.1055/a-1379-4898 ◽

2021 ◽

Vol 53 (01) ◽

pp. 22-26

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Female Population ◽

Population Controls

Doege D, Thong MS, Koch-Gallenkamp L et al.Age-specific prevalence and determinants of depression in long-term breast cancer survivors compared to female population controls. Cancer Med 2020; 9: 8713–8721. doi:10.1002/cam4.3476

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Adherence to follow-up recommendation guidelines in long term breast cancer survivors, a SURBCAN cohort analysis using administrative databases

The Breast ◽

10.1016/s0960-9776(21)00243-5 ◽

2021 ◽

Vol 56 ◽

pp. S80-S81

Author(s):

P. Santiá ◽

A. Jansana ◽

T. Sanz ◽

I. de la Cura ◽

M. Padilla-Ruiz ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cohort Analysis ◽

Administrative Databases

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Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study

Cancers ◽

10.3390/cancers13061301 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1301

Author(s):

Saskia W. M. C. Maass ◽

Daan Brandenbarg ◽

Liselotte M. Boerman ◽

Peter F. M. Verhaak ◽

Geertruida H. de Bock ◽

...

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

General Practitioner ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Breast Cancer Diagnosis ◽

Reference Population ◽

Cross Sectional ◽

Symptoms Of Depression

Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue. Design and Setting: A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner. Method: Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors. Results: Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4–2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1–40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6–11.4]). Conclusion: One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety.

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