Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

Boukheris, Houda; Rubino, Carole; Arriagada, R.; Delaloge, Suzette; Koscielny, Serge; Giardini, M; Lê, Monique G.; Vathaire, Florent de

doi:10.1080/02841860802167482

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…Irradiation therapy may increase the risk of CVD mortality by activating acute inflammatory cascades and develop myocardial fibrosis leading to the injury of cardiac muscle or the surrounding vasculature [ 16 , 17 , 18 ]. However, our findings, in contrast to some others [ 19 , 20 ], of reduced risk in CVD mortality among breast cancer patients receiving radiotherapy suggested that irradiation was less hazardous to the heart and more targeted to breast cancer after the 1990s with the development and improvement of techniques and regimens. In addition, some chemotherapy (e.g., anthracycline, trastuzumab) may lead to an increased risk of CVD mortality by damaging the circulatory system [ 5 , 21 ].…”

Section: Discussioncontrasting

confidence: 99%

Relative Risk of Cardiovascular Mortality in Breast Cancer Patients: A Population-Based Study

Wang¹,

He²,

Wang³

et al. 2022

Rev. Cardiovasc. Med.

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Aims:To investigate the risk of cardiovascular disease (CVD) mortality in breast cancer patients compared with the general female population. Methods: Data was retrieved from the Surveillance, Epidemiology, and End Results database. 924,439 female breast cancer patients who were at the age of follow-up ≥30 years and diagnosed during 1990-2016 as well as the aggregated general female population in the US were included. Using multivariable Poisson regression, we calculated incidence rate ratios (IRRs) of CVD mortality among female breast cancer patients compared with the female population. Results: The risk of CVD mortality was mildly increased among breast cancer patients at the age of follow-up 30-64 years (IRR 1.06, 95% confidence interval [CI] 1.03-1.10) compared with the general population. This growth of risk reached its peak within the first month after diagnosis (IRR 3.33, 95% CI 2.84-3.91) and was mainly activated by diseases of the heart (IRR 1.11, 95% CI 1.07-1.15). The elevation was greatest in survivors at the age of follow up 30-34 years (IRR 3.50, 95% CI 1.75-7.01). Conclusions: Clinicians should provide risk mitigation strategies with early monitoring of CVD mortality for breast cancer survivors, especially those who were young or with aggressive tumor stage.

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Section: Discussioncontrasting

confidence: 99%

Relative Risk of Cardiovascular Mortality in Breast Cancer Patients: A Population-Based Study

Wang¹,

He²,

Wang³

et al. 2022

Rev. Cardiovasc. Med.

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“…9,35-39 Radiation therapy, in particular to the left side of the chest wall, may increase CVD risk through injury to cardiac muscle or the surrounding vasculature. 40 However, several recent studies have failed to observe a difference in cardiac events between women receiving radiation therapy for left- vs. right-sided tumors.…”

Section: Discussionmentioning

confidence: 99%

“…41,42 It is also possible that the severity or form of radiation-induced CVD is less fatal than chemotherapy-induced disease, as our outcome was mortality rather than incident disease. Alternatively, radiation-induced CVD could take longer to manifest than we have available follow-up, as studies have found an increase in risk of morbidity or mortality more than 15 years 36 to 20 years 37,39 after treatment, a time period several years past what we had available. Other reports have found a synergistic effect between radiotherapy and other systemic therapies 13 that we did not have the study power to examine here.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Disease Mortality Among Breast Cancer Survivors

Bradshaw¹,

et al. 2016

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Background Cardiovascular disease (CVD) is of increasing concern among breast cancer survivors. However the burden of this comorbidity in this group relative to the general population, and its temporal pattern, remains unknown. Methods We compared deaths due to CVD in a population-based sample of 1,413 women with incident breast cancer diagnosed in 1996-1997, and 1,411 age-matched women without breast cancer. Date and cause of death through December 31, 2009 were assessed through the National Death Index and covariate data was gathered through structured interviews and medical record abstraction. Hazard ratios and 95% confidence intervals (CI) were calculated using Cox regression for overall mortality (HR) and CVD-specific death (cause-specific HR). Subdistribution hazard ratios (sHR) for CVD death were estimated from the Fine-Gray model. Results Risk of death was greater among breast cancer survivors compared to women without breast cancer [HR: 1.8 (1.5, 2.1)]. An increase in CVD-related death among breast cancer survivors was evident only 7 years after diagnosis [years 0-7, cause-specific HR: 0.80 (0.53, 1.2), subdistribution HR: 0.59 (0.40, 0.87)]; years 7+, cause-specific HR: 1.8 (1.3, 2.5), subdistribution HR: 1.9 (1.4, 2.7); p-interaction: 0.001]. An increase in CVD-related mortality was observed among breast cancer survivors receiving chemotherapy. Conclusions Breast cancer survivors are at greater risk for CVD-related mortality compared to women without breast cancer and this increase in risk is manifest approximately 7 years after diagnosis. Efforts should be made to identify risk factors and interventions that can be employed during this brief window to reduce the excess burden of CVD in this vulnerable population.

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“…It accounted for 33% of all female incident cancers and approximately 15% of all incident cancers in both sexes in 2011. [6][7][8][9] The treatment strategy for BC is based on the initial stage of the tumor, the patient's age, general health, tumor histology and prognostic factors. 4,5 This improvement is assumed to be the result of earlier diagnosis, particularly the use of mammography or mass-screening campaigns, and treatment effects, particularly the use of effective adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 This improvement is assumed to be the result of earlier diagnosis, particularly the use of mammography or mass-screening campaigns, and treatment effects, particularly the use of effective adjuvant therapy. [6][7][8][9] The treatment strategy for BC is based on the initial stage of the tumor, the patient's age, general health, tumor histology and prognostic factors. 10 In recent years, variations in BC treatment with age have become an important issue.…”

Section: Introductionmentioning

confidence: 99%

In breast cancer, are treatments and survival the same whatever a patient's age? A population‐based study over the period 1998–2009

Dialla

Quipourt²,

Gentil

et al. 2014

Geriatrics Gerontology Int

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Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

Cited by 5 publications

References 29 publications

Relative Risk of Cardiovascular Mortality in Breast Cancer Patients: A Population-Based Study

Relative Risk of Cardiovascular Mortality in Breast Cancer Patients: A Population-Based Study

Cardiovascular Disease Mortality Among Breast Cancer Survivors

In breast cancer, are treatments and survival the same whatever a patient's age? A population‐based study over the period 1998–2009

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