10-year survivors of early breast cancer had a decreased risk of stroke compared with the general population (SIR 0.8; 95% CI 0.6-0.9), although hormonal treatment was associated with increased risk (HR 1.9).
Cohort (n=4,414)
Do specific breast cancer treatments increase the risk of cerebrovascular events in long-term survivors?
Long-term breast cancer survivors do not have an increased overall risk of stroke compared to the general population, although tamoxifen use is associated with a higher risk.
Estimación del efecto: SIR 0.8 (95% CI 0.6 to 0.9)
PURPOSE: To assess treatment-specific risk of cerebrovascular events in early breast cancer (BC) patients, accounting for cerebrovascular risk factors. PATIENTS AND METHODS: We studied the incidence of cerebrovascular accidents (CVA; stroke and transient ischemic attack TIA) in 10-year survivors of early BC (n = 4,414) treated from 1970 to 1986. Follow-up was 96% complete until January 2000. Treatment-specific incidence of CVA was evaluated by standardized incidence ratios (SIRs) based on comparison with general population rates and by Cox proportional hazards regression. RESULTS: After a median follow-up of 18 years, 164 strokes and 109 TIAs were observed, resulting in decreased SIRs of 0.8 (95% CI, 0.6 to 0.9) for stroke and 0.8 (95% CI, 0.7 to 1.0) for TIA. Significantly increased risk of stroke was found in women who had received hormonal treatment (HT; tamoxifen) and in women who had hypertension or hypercholesterolemia, with hazard ratios (HRs) of 1.9, 2.1, and 1.6, respectively. Patients irradiated on the supraclavicular area and/or internal mammary chain (IMC) did not experience a higher risk of stroke (HR = 1.0; 95% CI, 0.7 to 1.6) or TIA (HR = 1.4; 95% CI, 0.9 to 2.5) compared with patients who did not receive radiotherapy or who were irradiated on fields other than the supraclavicular area or IMC. CONCLUSION: Long-term survivors of BC experience no increased risk of cerebrovascular events compared with the general population. HT is associated with an increased risk of stroke. Radiation fields including the carotid artery do not seem to increase the risk of stroke compared with other fields.
Hooning et al. (Tue,) conducted a cohort in Early breast cancer (n=4,414). Early breast cancer survivorship vs. General population was evaluated on Stroke (SIR 0.8, 95% CI 0.6 to 0.9). 10-year survivors of early breast cancer had a decreased risk of stroke compared with the general population (SIR 0.8; 95% CI 0.6-0.9), although hormonal treatment was associated with increased risk (HR 1.9).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: