Association of cancer treatment with excess heart age among young breast cancer survivors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12081-12081
Author(s):  
Jacqueline B Vo ◽  
Shoshana M. Rosenberg ◽  
Philip Daniel Poorvu ◽  
Kathryn Jean Ruddy ◽  
Rulla Tamimi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Endocrine Therapy ◽  
Breast Cancer Survivors ◽  
Cvd Risk ◽  
Young Breast Cancer ◽  
Heart Age

12081 Background: Young women with breast cancer may be at increased risk for premature development of cardiovascular disease (CVD) in part due to their cancer treatment. Limited data are available on CVD risk among young breast cancer survivors. Methods: Women aged 30-40 years at diagnosis with stage 0-III breast cancer enrolled in a prospective cohort study of women diagnosed with breast cancer at ≤40 were eligible for inclusion in this analysis. Data were obtained from serial surveys and electronic medical records at breast cancer diagnosis and 5-year follow-up. We calculated “excess heart age,” which incorporates a CVD risk-based score (calculated using age, systolic blood pressure, blood pressure medication, diabetes, smoking, body mass index) to estimate the difference in years between an individual’s chronological age and their CVD-risk adjusted age. Multivariable logistic regression models (adjusting for age at diagnosis, stage, and race) were fitted to evaluate associations between treatment (radiation, endocrine therapy, anthracyclines, and trastuzumab) and having a change in excess heart age ≥2 years from baseline to 5 years. Results: Among 372 young breast cancer survivors, mean age at diagnosis was 36.6 (SD 2.89), 93% were white, and 79% were diagnosed with stage I or II breast cancer. Mean excess heart age was.32 (SD: 6.16) years at baseline, which declined to -.07 (SD 6.64) at 5-year follow-up (p=.17). At 5 years, 31% (n=114) of women experienced an increase of at least 2 years in their excess heart age since diagnosis, and their mean excess heart age was 4.34 years (range -9 to 30). In multivariable analyses, receipt of trastuzumab was associated with higher odds (OR: 1.68, 95% CI: 1.02-2.77) of experiencing an increase of ≥2 years in excess heart age between diagnosis and 5 years of follow-up. Endocrine therapy, anthracyclines, and radiation were not significantly associated with a change in excess heart age of ≥2 years at 5 years post-diagnosis. Conclusions: At 5 years post-diagnosis, approximately 1/3 of young breast cancer survivors experienced a change from baseline in their excess heart age of ≥2 years. Further research is warranted to confirm findings regarding trastuzumab and excess heart age, and potential effects on longer-term cardiac outcomes in this population. Extended follow-up of this cohort may further quantify CVD risk over time.[Table: see text]

Excess heart age in young breast cancer survivors over 2-year follow-up

2021 ◽  
Author(s):  
Jacqueline B. Vo ◽  
Kelly M. Kenzik ◽  
Wendy Landier ◽  
Dheeraj Raju ◽  
James K. Kirklin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Young Breast Cancer ◽  
Heart Age

Follow-up of long-term young breast cancer survivors.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 8-8
Author(s):  
Corinne Daly ◽  
Elisabeth M. Del Giudice ◽  
Rinku Sutradhar ◽  
Lawrence Frank Paszat ◽  
Drew Wilton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Registry ◽  
Breast Cancer Survivors ◽  
Negative Binomial ◽  
Population Based ◽  
Cancer Center ◽  
Physician Visits ◽  
Young Breast Cancer

8 Background: Evidence suggests breast cancer patients can be offered follow-up by family physician without concern of important recurrence–related serious clinical events occurring more frequently or quality of life being negatively affected. This study describes population-based patterns of follow-up care in 5-year recurrence-free young breast cancer survivors to determine factors influencing continued oncology follow-up in Ontario, Canada. Methods: We conducted a retrospective population-based cohort study using cancer registry and administrative data. Women diagnosed with an incident breast cancer aged 20-44 between 1992 and 1999, survived for at least 5 years and recurrence-free for 5 years past diagnosis were identified in the Ontario Cancer Registry. Each survivor was matched to 5 control women with the same calendar year of birth and place of residence in Ontario. We determined outpatient physician visits with primary care, medical, radiation and surgical oncology physicians to investigate trends associated with increasing survivorship and compared visit rates to controls. We used negative binomial regression to investigate factors predicting high utilization of oncology services among survivors after 5-year recurrence survival. Results: We identified 4,581 survivors and 22,898 controls. By year 10, 51% breast cancer survivors were still being followed by an oncologist. In the survivors, fewer physician visits were observed among recurrence-free breast cancer survivors as time increased from diagnosis (Visit Rate Ratio [VRR] =0.95, 95% CI: 0.94, 0.96). Breast cancer survivors diagnosed from 1992-1995 had a higher rate of physician visits than those diagnosed from 1996-1999 (VRR = 1.16, 95% CI: 1.07, 1.25). More oncologist visits were associated with patients visiting a female oncologist (VRR = 1.20, 95% CI: 1.09, 1.33) and fewer visits were associated with patients visiting an oncologist who practiced outside of a regional cancer center (VRR = 0.67, 95% CI: 0.58, 0.77). Conclusions: Oncology visits of young breast cancer survivors after 5-year survival were associated with oncologist factors indicating that prolonged oncology follow-up in breast cancer survivors may be driven by practice patterns rather than patients’ needs.

Measuring knowledge gained for young breast cancer survivors and co-survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 213-213
Author(s):  
Lori Atkinson ◽  
Michelle Esser ◽  
Nirmala Singh ◽  
Jean Rowe ◽  
Megan McCann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Online Surveys ◽  
Self Confidence ◽  
Global Organization ◽  
Critical Issues ◽  
Baseline Knowledge ◽  
Young Breast Cancer

213 Background: Cancer impacts not just the survivor, but those caring for her. Young Survival Coalition (YSC) is the premier global organization dedicated to critical issues in young breast cancer survivors (YBCS) and co-survivors. In 2015, targeted programming was introduced at YSC’s Northeast Regional Symposium. Prior to the event, YSC crafted pre- and post-surveys to measure knowledge gained through the Symposium as an intervention for YBCS and co-survivors. Methods: YSC disseminated pre- and post-event evaluations via online surveys. The pre-survey was sent to registrants (240; 75 completed), and the post-survey was sent to attendees (178; 99 completed). The surveys were designed to measure baseline and increased knowledge in the 4 areas presented at the Symposium: Sex and Intimacy (S&I), Practical Matters (PM), Resiliency and Communication. Questions included demographics, diagnosis, identification as YBCS/co-survivor and baseline knowledge in the 4 areas. Questions in the post-survey followed the same format and measured knowledge gained from the Symposium. Results: In pre-survey data, YBCS and co-survivors most wanted knowledge and resources in S&I and PM. Seventy-five percent reported S&I as a challenge since diagnosis, and 51% stated communication in relationships was difficult. Twenty-two percent felt they did not have the resources they needed to address PM, while 20% felt unsure about what resources they needed. Following the Symposium, 74% felt that they had tools and resources to help in their everyday life as it relates to S&I after the Symposium. Sixty-seven percent reported gaining knowledge they did not have prior to attending. S&I as it relates to YBCS (partnered or single) and rebuilding self-confidence were areas where more information was desired. Seventy-five percent indicated they received information on PM of which they were unaware prior to attending. Follow-up care, financial concerns and career were areas where more information was desired. Conclusions: YBCS and their co-survivors are in need of support and information that is targeted and easily accessible. YSC will continue crafting specific programming for YBCS and co-survivors and measuring the knowledge of both to stay current with their needs.

Asymptomatic cardiotoxicity in long-term breast cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24084-e24084
Author(s):  
Mohammed Alaeddine Saidi ◽  
Soumeyya Ghomari
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Early Breast Cancer ◽  
Breast Cancer Survivors ◽  
Left Ventricular ◽  
Left Ventricular Ejection

e24084 Background: Multimodal approach in the adjuvant treatment of early breast cancer has led to a significant number of survivors. However, the combination of these treatments may increase the risk of long-term cardiotoxicity, particularly in the presence of cardiovascular risk factors (CVRF). Methods: We examined cardiac function in patients who had previously been treated for early breast cancer. Echocardiograms were performed at least 2 years after therapy. We measured left ventricular ejection fraction (LVEF) and reported pre-treatment LVEF and all CVRF. The initial Framingham Risk Score (FRS) has been calculated. Asymptomatic cardiotoxicity was defined by decrease of 5% or more in the LVEF value without clinical symptoms of CHF. Doxorubicin, Trastuzumab, Radiotherapy, older age, and CVRF (hypertension (HTN), diabetes, dyslipidemia, obesity, Waist circumference) were evaluated as potential risk factors for the development of cardiotoxicity. All statistical analysis was performed using SPSS version 25.0. Results: A total of 143 breast cancer survivors with a median age of 46 ± 10 years (range: 26-72) underwent Echocardiogram imaging after a median follow-up of 9,22 years (range: 2 - 22). 48 women were postmenopausal at diagnostic. 32,2% were obese. HTN was present in 15%, diabetes in 12%, and dyslipidemia in 12% of patients. ARA-II was the most used treatment of HTN (55%). 11,9% of patients were under statin therapy. FRS was low in 69%, moderate in 22% and high in 9% of patients. 4 patients had received endocrine therapy alone, none of whom developed cardiotoxicity. There was only one case of symptomatic cardiotoxicity. In the remaining 138 women who received multimodal treatment (Anthracyclines:100%, Docetaxel:62,9%, Endocrine therapy:72%, Trastuzumab:7%, Radiotherapy:83,2%), a statistical but non-clinically significant decrease was observed in LVEF (67.7 ± 3.6 to 65.4 ± 5.1, p < 0.001). 39 women (28,3%) developed asymptomatic cardiotoxicity. In multivariate analysis, factors that contributed to decreased LVEF were HTN (p = 0,006), diabetes (p = 0,008) and dyslipidemia (p = 0,03). Conclusions: The use of adjuvant therapy in breast cancer may increase long term cardiotoxicity particularly in survivors with CVRF. Long-term cardiac follow-up is essential in order to initiate cardioprotective therapy at the right time.

scholarly journals Therapy choices and quality of life in young breast cancer survivors: a short-term follow-up

2013 ◽  
Vol 206 (5) ◽  
pp. 625-631 ◽  
Author(s):  
Marie Catherine Lee ◽  
Rajendra S. Bhati ◽  
Edina E. von Rottenthaler ◽  
Angela M. Reagan ◽  
Sloan B. Karver ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Short Term ◽  
Young Breast Cancer

scholarly journals Accuracy of self-reported cancer treatment data in young breast cancer survivors

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Kelly C. Gast ◽  
Elizabeth J. Cathcart-Rake ◽  
Aaron Norman ◽  
Leah Eshraghi ◽  
Nwamaka Obidegwu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Breast Cancer Survivors ◽  
Treatment Data ◽  
Young Breast Cancer

Body weight changes in young breast cancer survivors and associated predictors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11574-11574
Author(s):  
Tal Sella ◽  
Zhenying Tan-Wasielewski ◽  
Shoshana M. Rosenberg ◽  
Philip Daniel Poorvu ◽  
Kathryn Jean Ruddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Prospective Cohort ◽  
Menopausal Status ◽  
Weight Changes ◽  
Young Breast Cancer ◽  
The Impact

11574 Background: Weight gain after cancer diagnosis is common in cancer survivors and has been linked to increased treatment toxicity, poor quality of life, and increased risk of second cancers and overall mortality. Young breast cancer (BC) survivors may be especially susceptible to weight changes given the impact of treatments such as chemotherapy and hormonal therapy on menopausal status. Methods: We identified women with Stage 0-III breast cancer diagnosed at ≤40 years (y) between 2006-2016 from a multi-center prospective cohort study. Clinical data including self-reported pre-diagnosis and follow-up weights were obtained using baseline and follow-up patient surveys. Participants missing baseline weight, pregnant at diagnosis/within 1y of diagnosis or with BC recurrence within 1y were excluded; those pregnant or with BC recurrence between 1-3y from diagnosis were excluded from the 3y analysis. Menopausal status at baseline and treatment-related amenorrhea (TRA) in follow-up were defined by self-reported last menstrual period. Factors associated with weight gain (>5%) were evaluated using univariate two-sided Fisher's exact test. Results: At baseline, 1y and 3y post diagnosis, 956, 899 and 687 women were eligible for analysis respectively. Median age at diagnosis was 37y (17 - 40), 65% received endocrine therapy and 74% chemotherapy. Premenopausal status was verified in 94% at baseline. Mean BMI at baseline was 24.4 (SD 5.3) kg/m2; 20% (187/956) were overweight and 12% (116/956) obese. At 1y and 3y, mean BMI increased modestly to 24.7 (SD 5.6) and 24.9 (SD 5.2), respectively with weight gain (>5%) observed in 18% (164/899) and 13% (87/687) respectively. 37% (300/804) and 32% (196/615) of eligible premenopausal subjects experienced TRA at 1y and 3y, respectively. Receipt of chemotherapy, receipt of endocrine therapy and TRA were not associated with weight gain at any timepoint. Conclusions: In this large prospective cohort of young BC survivors, mean BMI increased only modestly over time. Self-reported weight gain was not associated with treatment and not exacerbated by TRA. Further analysis to understand the effects of physical activity and other predictors of weight gain in this population are ongoing.

Impact of fertility concerns on endocrine therapy decisions in young breast cancer survivors

Cancer ◽  
2021 ◽  
Author(s):  
Tal Sella ◽  
Philip D. Poorvu ◽  
Kathryn J. Ruddy ◽  
Shari I. Gelber ◽  
Rulla M. Tamimi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Breast Cancer Survivors ◽  
Young Breast Cancer

scholarly journals Use of Integrative Oncology, Involvement in Decision-Making, and Breast Cancer Survivor Health-Related Quality of Life in the First 5 Years Postdiagnosis

2018 ◽  
Vol 17 (3) ◽  
pp. 636-645 ◽  
Author(s):  
M. Robyn Andersen ◽  
Erin Sweet ◽  
Shelly Hager ◽  
Marcia Gaul ◽  
Fred Dowd ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Breast Cancer Survivors ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Objective: This study sought to describe changes in the health-related quality of life (HRQOL) of women who do and do not seek naturopathic oncology (NO) complementary and alternative medicine (CAM) care during and immediately after breast cancer treatment, and to explore the predictive role of NO CAM care, demographic characteristics, and involvement in decision-making on HRQOL in breast cancer survivors. Methods: Matched cohorts of breast cancer survivors who did and did not choose to supplement their breast cancer treatment with NO care within 2 years of diagnosis participated. NO users were identified through naturopathic doctors’ clinics and usual care (UC) controls with similar prognosis were identified through a cancer registry. The registry provided information about all participants’ age, race, ethnicity, marital status, stage of cancer at time of diagnosis, date of diagnosis, and use of conventional medical treatments (surgery, chemotherapy, radiation, and endocrine therapy). Data of participants’ self-reported involvement in decision-making and HRQOL were collected at study enrollment and at 6-month follow-up. Results: At 6-month follow-up, the NO patients reported significantly more involvement in decision-making about care and better general health than did UC patients ( P < .05). Self-reported involvement in decision-making about cancer treatment was associated with better role-physical, role-emotional, and social-functional well-being ( P < .05). Race, age, marital status, and congruence of preferred and achieved levels of involvement also predicted aspects of HRQOL in breast cancer survivors ( P < .05). Conclusions: Both NO CAM care and involvement in decision-making about cancer treatment may be associated with better HRQOL in breast cancer survivors.

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