Breast cancer: 25-year data show higher overall, CVD mortality

  • Ramin C & al.
  • J Natl Cancer Inst
  • 7 Jul 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Women with breast cancer vs women without cancer appear to have higher overall mortality and higher cardiovascular disease (CVD)-related mortality after 25 years of follow-up, according to this analysis from the CLUE II cohort study.

Why this matters

  • Clinicians should monitor and treat CVD-related conditions in long-term survivors of breast cancer.

Study design

  • Community-based prospective cohort study (n=628 women with breast cancer and 3140 age-matched participants without cancer).
  • Funding: NIH; Breast Cancer Research Foundation.

Key results

  • After 25-year follow-up, survivors of breast cancer had an almost 80% greater overall risk for mortality than control participants:
    • aHR, 1.79 (95% CI, 1.53-2.09).
  • Mortality risk was highest among older survivors (age ≥70 years) who were >15 years postdiagnosis:
    • aHR, 2.69 (95% CI, 1.59-4.55).
  • CVD was the foremost cause of death among control participants and the second leading cause among survivors of breast cancer.
  • Survivors vs control participants had a 65% greater risk for CVD-related death starting 8 years after diagnosis:
    • aHR, 1.65 (95% CI, 1.00-2.73).
  • The greatest risk was seen: 
    • Among older survivors: aHR, 2.24 (95% CI, 1.29-3.88).
    • With estrogen receptor-positive disease: aHR (1.85; 95% CI, 1.06-3.20).

Limitations

  • Observational.
  • Unable to perform subgroup analysis of breast cancer treatment type.