Anne Gulbech Ording1, Paolo Boffetta2, Jens Peter Garne3, Petra Mariann Witt Nyström4, Deirdre Cronin-Fenton5, Trine Frøslev5, Rebecca Silliman6, Henrik Toft Sørensen5, Timothy L Lash7. 1. Department of Clinical Epidemiology, Aarhus University Hospital, Denmark. Electronic address: ao@clin.au.dk. 2. Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, NY, USA. 3. Breast Clinic, Aalborg Hospital, Aalborg University Hospital, Denmark. 4. Department of Oncology, Uppsala University Hospital, Sweden. 5. Department of Clinical Epidemiology, Aarhus University Hospital, Denmark. 6. Department of Medicine, Boston University School of Medicine, Boston, MA, USA. 7. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Abstract
BACKGROUND: It remains unknown whether incident chronic diseases are more often fatal among breast cancer survivors than among women free of breast cancer. METHODS: We conducted a nationwide matched cohort study of all Danish breast cancer patients diagnosed between 1994 and 2007, who survived for five years. We compared their long-term mortality with five times as many women from the general population without breast cancer, matched on age. We used time-varying methods to compute mortality rate ratios (MRRs) for incident diseases included in the Charlson Comorbidity Index (CCI). RESULTS: One third of five-year breast cancer survivors developed incident diseases during 14 years of follow-up, with about the same incidence as women without breast cancer. Mortality associated with any incident disease was similar among breast cancer survivors (MRR = 7.1, 95% confidence interval (CI): 6.7, 7.4) and comparison women (MRR = 7.5, 95% CI: 7.3, 7.7). Among breast cancer patients, relative mortality associated with incident diseases was higher among patients treated with chemotherapy (MRR = 10, 95% CI: 8.7, 12) and radiotherapy (MRR = 9.8, 95% CI: 8.8, 11) than among patients who received surgery (MRR = 7.0, 95% CI: 6.7, 7.4) or hormonal therapy (MRR = 6.3, 95% CI: 5.8, 6.9). CONCLUSION: There were no marked differences in mortality of diseases among breast cancer survivors and women from the general population. Among breast cancer patients, new diseases were more often fatal in patients treated with chemotherapy and radiotherapy. Five-year breast cancer survivors have similar risk of dying from new chronic medical conditions as women from the general population without breast cancer.
BACKGROUND: It remains unknown whether incident chronic diseases are more often fatal among breast cancer survivors than among women free of breast cancer. METHODS: We conducted a nationwide matched cohort study of all Danish breast cancerpatients diagnosed between 1994 and 2007, who survived for five years. We compared their long-term mortality with five times as many women from the general population without breast cancer, matched on age. We used time-varying methods to compute mortality rate ratios (MRRs) for incident diseases included in the Charlson Comorbidity Index (CCI). RESULTS: One third of five-year breast cancer survivors developed incident diseases during 14 years of follow-up, with about the same incidence as women without breast cancer. Mortality associated with any incident disease was similar among breast cancer survivors (MRR = 7.1, 95% confidence interval (CI): 6.7, 7.4) and comparison women (MRR = 7.5, 95% CI: 7.3, 7.7). Among breast cancerpatients, relative mortality associated with incident diseases was higher among patients treated with chemotherapy (MRR = 10, 95% CI: 8.7, 12) and radiotherapy (MRR = 9.8, 95% CI: 8.8, 11) than among patients who received surgery (MRR = 7.0, 95% CI: 6.7, 7.4) or hormonal therapy (MRR = 6.3, 95% CI: 5.8, 6.9). CONCLUSION: There were no marked differences in mortality of diseases among breast cancer survivors and women from the general population. Among breast cancerpatients, new diseases were more often fatal in patients treated with chemotherapy and radiotherapy. Five-year breast cancer survivors have similar risk of dying from new chronic medical conditions as women from the general population without breast cancer.
Authors: Rebecca L Sedjo; Shirley W Flatt; Tim Byers; Graham A Colditz; Wendy Demark-Wahnefried; Patricia A Ganz; Kathleen Y Wolin; Anthony Elias; Helen Krontiras; Jingxia Liu; Michael Naughton; Bilgé Pakiz; Barbara A Parker; Holly Wyatt; Cheryl L Rock Journal: Support Care Cancer Date: 2016-03-05 Impact factor: 3.603
Authors: Elizabeth J Siembida; Ashley Wilder Smith; Arnold L Potosky; Kristi D Graves; Roxanne E Jensen Journal: Qual Life Res Date: 2021-01-14 Impact factor: 3.440