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Long-Term Risk of Death From Heart Disease Among Breast Cancer Patients

Aya Agha1, Xi Wang2, Ming Wang2

  • 1Department of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, United States.

Frontiers in Cardiovascular Medicine
|May 2, 2022
PubMed

Insights

Breast cancer survivors face a significant risk of fatal heart disease, especially older patients receiving chemotherapy. Early referral to cardio-oncology can help manage this long-term risk.

Area of Science:

  • Cardiology
  • Oncology
  • Public Health

Background:

  • Most breast cancer deaths are from non-cancer causes.
  • Heart disease is a leading cause of death in these patients.
  • Long-term risk of fatal heart disease is not well understood.

Purpose of the Study:

  • To characterize the long-term risk of fatal heart disease in breast cancer patients.
  • To identify patient groups at higher risk for cardiac mortality.
  • To inform preventative strategies for cardiovascular complications.

Main Methods:

  • Retrospective study using the Surveillance, Epidemiology, and End Results (SEER) database.
  • Analysis of 1,059,048 breast cancer patients diagnosed between 1992 and 2014.
  • Calculation of Standard Mortality Ratios (SMR), Hazard Ratios (HRs), and Odds Ratios (ORs) stratified by treatment and patient factors.

Main Results:

  • 4.6% of breast cancer patients died from heart disease.
  • 10+ year SMR for heart disease was 2.92 with radiotherapy and 5.05 with chemotherapy.
  • Risk of fatal heart disease increased with age (>70) and longer follow-up periods.

Conclusions:

  • Older breast cancer patients, particularly those receiving chemotherapy and with longer follow-up, have the highest risk of fatal heart disease.
  • These high-risk patients warrant referral to cardio-oncology services.
  • Proactive cardiac care is crucial for improving long-term survival in breast cancer survivors.
Abstract

Keywords:
breast cancercardio-oncologychemotherapyheart diseaseradiotherapy

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