BACKGROUND: There is growing evidence that breast cancer survivors have higher cardiovascular disease (CVD) mortality relative to the general population. Information on temporal patterns for all-cause and CVD mortality among breast cancer survivors relative to cancer-free women is limited. METHODS: All-cause and CVD-related mortality were compared in 628 women with breast cancer and 3140 age-matched cancer-free women within CLUE II, a prospective cohort. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression for all-cause mortality, and Fine and Gray models for CVD-related mortality to account for competing risks. RESULTS: Over 25 years of follow-up, 916 deaths occurred (249 CVD related). Breast cancer survivors had an overall higher risk of dying compared with cancer-free women (HR = 1.79, 95% CI = 1.53 to 2.09) irrespective of time since diagnosis, tumor stage, estrogen receptor status, and older age at diagnosis (≥70 years). Risk of death was greatest among older survivors at more than 15 years after diagnosis (HR = 2.69, 95% CI = 1.59 to 4.55). CVD (69.1% ischemic heart disease) was the leading cause of death among cancer-free women and the second among survivors. Survivors had an increase in CVD-related deaths compared with cancer-free women beginning at 8 years after diagnosis (HR = 1.65, 95% CI = 1.00 to 2.73), with the highest risk among older survivors (HR = 2.24, 95% CI = 1.29 to 3.88) and after estrogen receptor-positive disease (HR = 1.85, 95% CI = 1.06 to 3.20). CONCLUSIONS: Breast cancer survivors continue to have an elevated mortality compared with the general population for many years after diagnosis. Preventing cardiac deaths, particularly among older breast cancer patients, could lead to reductions in mortality.
BACKGROUND: There is growing evidence that breast cancer survivors have higher cardiovascular disease (CVD) mortality relative to the general population. Information on temporal patterns for all-cause and CVDmortality among breast cancer survivors relative to cancer-free women is limited. METHODS: All-cause and CVD-related mortality were compared in 628 women with breast cancer and 3140 age-matched cancer-free women within CLUE II, a prospective cohort. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression for all-cause mortality, and Fine and Gray models for CVD-related mortality to account for competing risks. RESULTS: Over 25 years of follow-up, 916 deaths occurred (249 CVD related). Breast cancer survivors had an overall higher risk of dying compared with cancer-free women (HR = 1.79, 95% CI = 1.53 to 2.09) irrespective of time since diagnosis, tumor stage, estrogen receptor status, and older age at diagnosis (≥70 years). Risk of death was greatest among older survivors at more than 15 years after diagnosis (HR = 2.69, 95% CI = 1.59 to 4.55). CVD (69.1% ischemic heart disease) was the leading cause of death among cancer-free women and the second among survivors. Survivors had an increase in CVD-related deaths compared with cancer-free women beginning at 8 years after diagnosis (HR = 1.65, 95% CI = 1.00 to 2.73), with the highest risk among older survivors (HR = 2.24, 95% CI = 1.29 to 3.88) and after estrogen receptor-positive disease (HR = 1.85, 95% CI = 1.06 to 3.20). CONCLUSIONS:Breast cancer survivors continue to have an elevated mortality compared with the general population for many years after diagnosis. Preventing cardiac deaths, particularly among older breast cancerpatients, could lead to reductions in mortality.
Authors: Jaidyn Muhandiramge; John R Zalcberg; G J van Londen; Erica T Warner; Prudence R Carr; Andrew Haydon; Suzanne G Orchard Journal: Curr Oncol Rep Date: 2022-07-07 Impact factor: 5.075
Authors: Ana de la Fuente; Marta Santisteban; Josep Lupón; José Manuel Aramendía; Agnes Díaz; Ana Santaballa; Amparo Hernándiz; Pilar Sepúlveda; Germán Cediel; Begoña López; José María López Picazo; Manuel M Mazo; Gregorio Rábago; Juan José Gavira; Ignacio García-Bolao; Javier Díez; Arantxa González; Antoni Bayés-Genís; Susana Ravassa Journal: Cancers (Basel) Date: 2022-06-14 Impact factor: 6.575
Authors: Heather Greenlee; Carlos Iribarren; Jamal S Rana; Richard Cheng; Mai Nguyen-Huynh; Eileen Rillamas-Sun; Zaixing Shi; Cecile A Laurent; Valerie S Lee; Janise M Roh; Margarita Santiago-Torres; Hanjie Shen; Dawn L Hershman; Lawrence H Kushi; Romain Neugebauer; Marilyn L Kwan Journal: J Clin Oncol Date: 2022-04-06 Impact factor: 50.717
Authors: Helen Strongman; Sarah Gadd; Anthony A Matthews; Kathryn E Mansfield; Susannah Stanway; Alexander R Lyon; Isabel Dos-Santos-Silva; Liam Smeeth; Krishnan Bhaskaran Journal: JACC CardioOncol Date: 2022-03-15
Authors: Jacqueline B Vo; Cody Ramin; Ana Barac; Amy Berrington de Gonzalez; Lene Veiga Journal: Breast Cancer Res Treat Date: 2022-02-02 Impact factor: 4.872