Heart Failure and Long-Term Survival Among Older Women With Breast Cancer

Objectives: To evaluate the association between heart failure and overall survival up to 10 years after breast cancer diagnosis. Sample & Setting: Women aged 65 years or older diagnosed with invasive breast cancer, with and without self-reported heart failure, were examined for this retrospective cohort study using Surveillance, Epidemiology, and End Results cancer registries in the United States. Methods & Variables: Cox proportional hazards regression was used to examine the association between heart failure status and mortality, adjusting for comorbidity and other clinical or sociodemographic differences. Associations were examined overall and stratified by cancer stage. Results: In adjusted models, having heart failure was associated with increased likelihood of death up to 10 years after cancer diagnosis. In adjusted subanalyses by cancer stage, heart failure was associated with increased likelihood of death up to 10 years after cancer diagnosis in women with stage I or II cancer but not in women with stage III/IV cancer. Implications for Nursing: Although early-stage breast cancer is generally associated with better prognosis, the competing mortality risk of heart failure was greater for this group than for women with advanced cancer. Prevention and management of cardiovascular disease should be prioritized for this patient subgroup.