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The risk of heart-specific death in breast cancer patients
Yunbo Luo1,2, Long Zhao3, Peng Qu4,5,6
1Department of Breast Surgery, Plastic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, Sichuan, P.R. China.
Insights
Breast cancer survivors face a higher risk of heart-specific death (HSD) compared to the general population. Factors like race, age, and tumor stage influence this risk, necessitating targeted medical interventions.
Area of Science:
- Oncology
- Cardiology
- Epidemiology
Background:
- Improving breast cancer (BC) treatments leads to increased survival.
- Survivors are increasingly dying from non-cancer conditions, notably heart disease (HD).
Purpose of the Study:
- To analyze the risk of heart-specific death (HSD) in breast cancer patients.
- To identify demographic and clinicopathological risk factors for HSD in this population.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019).
- Calculated Standard Mortality Ratios (SMR) for HSD.
- Employed Cox Proportional hazard models to determine risk factors and 95% Confidence Intervals (CI).
Main Results:
- Included 655,552 breast cancer patients; 149,708 (22.8%) died.
- Heart disease caused 15.2% of deaths, becoming the leading cause after 10 years.
- The SMR for HD was 8.14, indicating significantly higher risk in BC patients.
- Race, age, marital status, income, grade, stage, and subtype were independent risk factors for HSD.
Conclusions:
- Breast cancer patients have a substantially elevated risk of heart-specific death.
- Demographic characteristics and tumor factors significantly influence HSD risk.
- Medical strategies are crucial to mitigate heart disease risk in breast cancer survivors.
Abstract:
With the improvement of comprehensive anti-cancer treatment for breast cancer (BC), more and more BC survivors will die from non-cancer diseases, including cardiovascular disease dominated by heart disease (HD). Therefore, this study aimed to analyze the risk of heart-specific death (HSD) in patients with BC by using the Surveillance, Epidemiology, and End Results (SEER) database. The eligible patients diagnosed with BC between 2000 and 2019 were exported from the SEER database. The standard mortality ratios (SMR) were calculated to compare the difference in HSD between patients with BC and the general population. The Cox Proportional hazard model was used to estimate the risk factors for HSD in BC patients and the 95% confidence intervals (CI) were calculated. Overall, 655,552 eligible patients were included in our study, and 149,708 (22.8%) patients died. Among the deaths, 22,718 (15.2%) cases were attributed HD which was the second cause of death for BC patients. With the extension of follow-up (> 10 years), HD surpassed breast cancer as the leading cause of death for BC (22.3% vs. 20.2%). The SMR for HD was 8.14 (95%CI: 8.04-8.25) in the whole cohort. Multivariate analysis showed that race, age, marital status, median household income, grade, stage and subtype were independent risk factors for HSD in BC patients. The risk of HSD is significantly higher in BC patients than in the general population and closely related to demographic characteristics and tumor clinicopathological factors. Medical approaches are needed to reduce the risk of HD among patients with BC.
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