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Cardiovascular disease leading cause of death in women with breast cancer

US study finds around 90% patients with early or advanced stage disease had at least one cardiac-related co-morbidity

US study finds around 90% patients with early or advanced stage disease had at least one cardiac-related co-morbidity


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Recent improvements in cancer treatment outcomes and the supportive management of adverse events and morbid side effects means that underlying cardiovascular disease has now replaced the original malignant disease related mortality as the foremost cause of death in women with breast cancer.

In this American study, published in the Journal of Clinical Oncology, researchers examined data from more than a decade of breast cancer trials from the Southwest Oncology Group to establish the correlation between cardiovascular risk factors, ischaemic heart events or failure and long-term cancer survival.

The information from almost 1,500 older adult patients participating in trials from 1999 to 2011 was appraised. The median follow-up period was six years.

Risk factors

Around nine in ten patients (87%) with early and advanced stage disease had at least one cardiac-related co-morbidity. Hypertension and hypercholesterolaemia were the most prevalent cardiac-related risk factors, appearing in 73% and 57% of the population respectively. More than half of the population studied had two or more cardiac co-morbidities.

The findings suggest that each cardiovascular risk factor had a strong association with an increased risk of death and reduced progression free survival and cancer-free survival.

Hypercholesterolaemia alone was associated with improved overall survival, possibly associated with statin use.

The researchers advocate attention be paid to controlling and lessening the unfavourable effect of modifiable risk factors, such as cholesterol levels, blood glucose levels and diabetes and blood pressure.

Hershman D et al (2018) Association of cardiovascular risk factors with cardiac events and survival outcomes among patients with breast cancer enrolled in SWOG clinical trials. Journal of Clinical Oncology. doi: 10.1200/JCO.2017.77.4414


Dion Smyth is a lecturer-practitioner in cancer and palliative care at Birmingham City University

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