Risk of Cardiovascular Diseases Among Older Breast Cancer Survivors in the United States: A Matched Cohort Study

Background: It has been suggested that cardiovascular risks are increased in breast cancer survivors, but few studies have quantified the risks of a range of specific clinically important cardiovascular outcomes in detail. Patients and Methods: Women aged >65 years with incident breast cancer from 2004 to 2013 in the SEER-Medicare linked database were matched with 5 cancer-free female counterparts (5:1 ratio). Prevalence of specific cardiovascular outcomes at baseline was measured, then Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals for the risk of individual cardiovascular outcomes during follow-up. Modification of the effect was investigated by time since diagnosis, race/ethnicity, prior cardiovascular disease (CVD), and age. Results: In all, 91,473 women with breast cancer and 454,197 without breast cancer were included. Women with breast cancer had lower baseline prevalence of all CVDs. Compared with cancer-free controls, breast cancer survivors had substantially increased risks of deep vein thrombosis (adjusted HR, 1.67; 95% CI, 1.62–1.73; 386,484 person-years of follow-up) and pericarditis (HR, 1.43; 95% CI, 1.38–1.49; 390,776 person-years of follow-up); evidence of smaller increased risks of sudden cardiac arrest, arrhythmia, heart failure, and valvular heart disease (adjusted HRs ranging from 1.05–1.09, lower CI limits all ≥1); and evidence of lower risk of incident angina, myocardial infarction, revascularization, peripheral vascular disease, and stroke (adjusted HRs ranging from 0.89–0.98, upper CI limits all ≤1). Increased risks of arrhythmia, heart failure, pericarditis, and deep vein thrombosis persisted >5 years after cancer diagnosis. Conclusions: Women with a history of breast cancer were at increased risk of several CVDs, persisting into survivorship. Monitoring and managing cardiovascular risk throughout the long-term follow-up of women diagnosed with breast cancer should be a priority.

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Mammography Surveillance and Mortality in Older Breast Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2006.09.9572 ◽

2007 ◽

Vol 25 (21) ◽

pp. 3001-3006 ◽

Cited By ~ 85

Author(s):

Timothy L. Lash ◽

Matthew P. Fox ◽

Diana S.M. Buist ◽

Feifei Wei ◽

Terry S. Field ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Cancer Mortality ◽

Breast Cancer Survivors ◽

Care Delivery ◽

Breast Cancer Mortality ◽

The United States ◽

Stage I ◽

Early Stage Disease

Purpose There are more than 2,000,000 breast cancer survivors in the United States today. While surveillance for asymptomatic recurrence and second primary is included in consensus recommendations, the effectiveness of this surveillance has not been well characterized. Our purpose is to estimate the effectiveness of surveillance mammography in a cohort of breast cancer survivors with complete ascertainment of surveillance mammograms and negligible losses to follow-up. Patients and Methods We enrolled 1,846 stage I and II breast cancer patients who were at least 65 years old at six integrated health care delivery systems. We used medical record review and existing databases to ascertain patient, tumor, and therapy characteristics, as well as receipt of surveillance mammograms. We linked personal identifiers to the National Death Index to ascertain date and cause of death. We matched four controls to each breast cancer decedent to estimate the association between receipt of surveillance mammogram and breast cancer mortality. Results One hundred seventy-eight women died of breast cancer during 5 years of follow-up. Each additional surveillance mammogram was associated with a 0.69-fold decrease in the odds of breast cancer mortality (95% CI, 0.52 to 0.92). The protective association was strongest among women with stage I disease, those who received mastectomy, and those in the oldest age group. Conclusion Given existing recommendations for post-therapy surveillance, trials to compare surveillance with no surveillance are unlikely. This large observational study provides support for the recommendations, suggesting that receipt of surveillance mammograms reduces the rate of breast cancer mortality in older patients diagnosed with early-stage disease.

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Prospective 12-Year Follow-up Study of Clinical and Hemodynamic Sequelae After Deep Vein Thrombosis in Low-Risk Patients (Zürich Study)

Circulation ◽

10.1161/01.cir.93.1.74 ◽

1996 ◽

Vol 93 (1) ◽

pp. 74-79 ◽

Cited By ~ 106

Author(s):

Ulrich K. Franzeck ◽

Ilse Schalch ◽

Kurt A. Jäger ◽

Ernst Schneider ◽

Jörg Grimm ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Low Risk ◽

Vein Thrombosis ◽

Follow Up Study ◽

Risk Patients ◽

Deep Vein

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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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Changes in the Semantic Construction of Compassion after the Cognitively-Based Compassion Training (CBCT®) in Women Breast Cancer Survivors

The Spanish Journal of Psychology ◽

10.1017/sjp.2021.31 ◽

2021 ◽

Vol 24 ◽

Author(s):

Edgar González-Hernández ◽

Daniel Campos ◽

Rebeca Diego-Pedro ◽

Rocío Romero ◽

Rosa Baños ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Semantic Differential ◽

Post Intervention ◽

Treatment As Usual ◽

Spanish Speaking ◽

Specific Culture ◽

Differential Categories

Abstract The growing body of research on compassion has demonstrated its benefits for healthcare and wellbeing. However, there is no clear agreement about a definition for compassion, given the novelty of the research on this construct and its religious roots. The aim of this study is to analyze the mental semantic construction of compassion in Spanish-speaking women breast cancer survivors, and the effects of the Cognitively-Based Compassion Training (CBCT®) on the modification of this definition, compared to treatment-as-usual (TAU), at baseline, post-intervention, and six-month follow-up. Participants were 56 women breast cancer survivors from a randomized clinical trial. The Osgood’s Semantic Differential categories (evaluative, potency, and activity scales) were adapted to assess the semantic construction of compassion. At baseline, participants had an undefined idea about compassion. The CBCT influenced subjects’ semantic construction of what it means to be compassionate. Findings could lead to future investigations and compassion programs that adapt to a specific culture or population.

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Post-thrombotic syndrome after deep vein thrombosis: The role of follow-up Doppler ultrasound

Medicina Clínica (English Edition) ◽

10.1016/j.medcle.2020.01.024 ◽

2021 ◽

Vol 156 (5) ◽

pp. 251-252

Author(s):

Francisco Galeano-Valle ◽

Jorge del-Toro-Cervera ◽

Pablo Demelo-Rodríguez

Keyword(s):

Deep Vein Thrombosis ◽

Doppler Ultrasound ◽

Vein Thrombosis ◽

Post Thrombotic Syndrome ◽

Deep Vein

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Predictors of long-term post-thrombotic syndrome following high proximal deep vein thrombosis: a cross-sectional study

Thrombosis Journal ◽

10.1186/s12959-020-00253-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Marit Engeseth ◽

Tone Enden ◽

Per Morten Sandset ◽

Hilde Skuterud Wik

Keyword(s):

Deep Vein Thrombosis ◽

Proximal Deep Vein Thrombosis ◽

Cross Sectional ◽

Clinical Criteria ◽

Vein Thrombosis ◽

Post Thrombotic Syndrome ◽

Younger Age ◽

Deep Vein

Abstract Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT. Methods During 2006–09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (> 1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression. Results Eighty-eight patients (52%) were included 8–10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93–0.99), and 1.23 (95% CI, 1.02–1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments. Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.

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The development of valvular incompetence after deep vein thrombosis: A follow-up study with duplex scanning

Journal of Vascular Surgery ◽

10.1016/s0741-5214(94)70218-7 ◽

1994 ◽

Vol 19 (6) ◽

pp. 1059-1066 ◽

Cited By ~ 55

Author(s):

Bert van Ramshorst ◽

Paul S. van Bemmelen ◽

Hans Hoeneveld ◽

Bert C. Eikelboom

Keyword(s):

Deep Vein Thrombosis ◽

Duplex Scanning ◽

Vein Thrombosis ◽

Follow Up Study ◽

Deep Vein

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Venous Thromboembolism

10.2310/vasc.2101 ◽

2017 ◽

Author(s):

Guillermo A. Escobar ◽

Peter K. Henke ◽

Thomas W. Wakefield

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Lower Extremity ◽

The United States ◽

Laboratory Evaluation ◽

Individual Risk ◽

Vein Thrombosis ◽

Clinical Scenarios ◽

Deep Vein

Deep vein thrombosis (DVT) and pulmonary embolism (PE) comprise venous thromboembolism (VTE). Together, they comprise a serious health problem as there are over 275,000 new VTE cases per year in the United States, resulting in a prevalence of one to two per 1,000 individuals, with some studies suggesting that the incidence may even be double that. This review covers assessment of a VTE event, initial evaluation of a patient suspected of having VTE, medical history, clinical presentation of VTE, physical examination, laboratory evaluation, imaging, prophylaxis against perioperative VTE, indications for immediate intervention (threat to life or limb), indications for urgent intervention, and management of nonemergent VTE. Figures show a modified Caprini score questionnaire used at the University of Michigan to determine individual risk of VTE and the indicated prophylaxis regimen; Wells criteria for DVT and PE; phlegmasia cerulea dolens secondary to acute left iliofemoral DVT after thigh trauma; compression duplex ultrasonography of lower extremity veins; computed tomographic angiogram of the chest demonstrating a thrombus in the pulmonary artery, with extension into the right main pulmonary; management of PE according to Wells criteria findings; management of PE with right heart strain in cases of massive or submassive PE; treatment of DVT according to clinical scenario; a lower extremity venogram of a patient with May-Thurner syndrome and its subsequent endovascular treatment; and various examples of retrievable vena cava filters (not drawn to scale). Tables list initial clinical assessment for VTE, clinical scenarios possibly benefiting from prolonged anticoagulation after VTE, indications for laboratory investigation of secondary thrombophilia, venous thromboembolic risk accorded to hypercoagulable states, and Pulmonary Embolism Rule-out Criteria Score to avoid the need for D-dimer in patients suspected of having PE. This review contains 11 highly rendered figures, 5 tables, and 167 references. Key words: anticoagulation; deep vein thrombosis; postthrombotic syndrome; pulmonary embolism; recurrent venous thromboembolism; thrombophilia; venous thromboembolism; PE; VTE; DVT

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Priorities in the Cardiovascular Care of Breast Cancer Survivors

Journal of Oncology Practice ◽

10.1200/jop.18.00027 ◽

2018 ◽

Vol 14 (4) ◽

pp. 205-211 ◽

Cited By ~ 5

Author(s):

Bonnie Ky

Keyword(s):

Breast Cancer ◽

Cardiovascular Disease ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Multidisciplinary Care ◽

The United States ◽

Cancer Therapies ◽

Clinical Prediction ◽

Cardiovascular Care ◽

Common Malignancy

Breast cancer is the most common malignancy in women with more than 3 million breast cancer survivors in the United States alone. Survivors of breast cancer suffer from an increased burden of cardiovascular risk factors and disease. The focus of this review is to describe the epidemiology of cardiovascular disease in breast cancer survivors, including the cardiovascular concerns observed with common cancer therapies. Strategies to improve upon the early detection and treatment of cardiovascular disease, including clinical prediction algorithms, biomarkers, and imaging measures are also reviewed, and the use of cardioprotective therapies to mitigate risk are summarized. Finally, the need for evidence-based research to inform and improve upon the multidisciplinary care of this growing population is highlighted.

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