Trends in heart disease mortality among breast cancer survivors in the US, 1975–2017
Key result
Heart disease mortality among breast cancer survivors declined significantly relative to the general population from 1975-1979 to 2010-2016 (SMR 0.74), but increased for regional stage patients treated with chemotherapy alone.
Why the study?
Heart disease is a major concern among breast cancer survivors partly due to cardiotoxic therapies, but long-term trends in heart disease mortality have not been well characterized.
What are the long-term trends in heart disease mortality among US breast cancer survivors by treatment type?
Study Design
Type
Cohort (n=516,916)
Multicenter
Yes
Structured PICO
What are the long-term trends in heart disease mortality among US breast cancer survivors by treatment type?
P
Population
516,916 female breast cancer survivors aged 18-84 years, diagnosed between 1975 and 2016 and surviving at least 12 months, followed for a median of 9.59 years.
O
Outcome
Heart disease mortality (Standardized mortality ratios and 10-year cumulative heart disease mortality estimates)hard clinical
Main Result
Effect estimate: SMR 0.74 (95% CI 0.69, 0.79)
p-value: p=< 0.001
Heart disease mortality has declined overall among breast cancer survivors since 1975, though an increasing trend was observed for regional stage patients treated with chemotherapy alone.
Limitations
- Lack of information on traditional cardiovascular disease risk factors (e.g., hypertension, diabetes, dyslipidemia)
- Lack of data on subsequent treatment and specific chemotherapy agents
- Potentially under-reported initial treatment
- Inability to evaluate SMRs by breast cancer subtype or hormone therapy use
- Lack of detailed treatment data
- Lack of data on cardiovascular management throughout cancer survivorship
Authors
Discussion
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Implication
Declining heart disease mortality trends in breast cancer survivors may inform survivorship care; leaves open treatment-specific contributions.
Cite This Study
Vo et al. (2022) conducted a cohort in Breast cancer (n=516,916). Breast cancer treatment vs. US general female population was evaluated on Heart disease mortality (Standardized mortality ratio) (SMR 0.74, 95% CI 0.69, 0.79, p=< 0.001). Heart disease mortality among breast cancer survivors declined significantly relative to the general population from 1975-1979 to 2010-2016 (SMR 0.74), but increased for regional stage patients treated with chemotherapy alone.