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Increased risk of arterial thromboembolism in older men with breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Male breast cancer is a rare and understudied disease predominantly affecting men over age 60. Risk of arterial thromboembolic events (ATE) in men increases with age. We examined ATE risk following primary breast cancer diagnosis in elderly men.

Methods

Men with primary breast cancer diagnoses from 2002 to 2011 were identified using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database. Cases were individually matched by age, sex, race, registry, and comorbidities with controls without cancer using SEER-Medicare’s 5% noncancer sample. Medicare claims were used to identify ATE, defined as myocardial infarction or ischemic stroke. Cumulative incidence of ATE was calculated using competing risk methodology, with death considered a competing event. Cox proportional hazards analysis was used to compare rates of ATE among cases and controls.

Results

Three months following primary breast cancer diagnosis, ATE risk in the cohort of 881 men was 80% higher than matched controls (hazard ratio 1.8; 95% confidence interval 1.0–3.2). Six months post-cancer diagnosis, 5.7% of cases had experienced ATE, whereas only 3.5% of controls had (HR 1.6; 95% CI 1.0–2.6). ATE risk remained elevated 12 months post-cancer diagnosis. Among cases, risk of death was threefold higher in men who developed ATE.

Conclusions

We provide population-based evidence that male breast cancer patients have a substantially elevated risk of ATE in the first year following a cancer diagnosis compared with matched controls. Care providers should consider this heightened risk when evaluating cardiovascular health in men with a recent breast cancer diagnosis.

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Abbreviations

ATE:

Arterial thromboembolic event

SEER:

Surveillance, Epidemiology, and End Results

MI:

Myocardial infarction

PEDSF:

Patient entitlement and diagnosis summary file

HR:

Hazard ratio

CI:

Confidence interval

OS:

Overall survival

AJCC:

American Joint Committee on Cancer

SIR:

Standardized incidence ratio

NCCN:

National Comprehensive Cancer Network

SD:

Standard deviation

HTN:

Hypertension

AF:

Atrial fibrillation

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Acknowledgements

The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries included in the SEER-Medicare database.

Funding

The work was funded by the US National Institutes of Health (P30 CA008748 and K23NS091395).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA

    Anne S. Reiner & Katherine S. Panageas

  2. Department of Neurology and Brain and Mind Research Institute, Weill Cornell Medicine, 525 East 68th Street, Room F610, New York, NY, 10065, USA

    Babak B. Navi & Lisa M. DeAngelis

  3. Department of Neurology, Memorial Sloan Kettering Cancer Center, 444 East 68th Street, 9th Floor, New York, NY, 10065, USA

    Babak B. Navi & Lisa M. DeAngelis

Authors
  1. Anne S. Reiner
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  2. Babak B. Navi
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  4. Katherine S. Panageas
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Correspondence to Anne S. Reiner.

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The authors declare that they have no conflict of interest.

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This research complies with the current laws of the country in which they were performed.

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Reiner, A.S., Navi, B.B., DeAngelis, L.M. et al. Increased risk of arterial thromboembolism in older men with breast cancer. Breast Cancer Res Treat 166, 903–910 (2017). https://doi.org/10.1007/s10549-017-4433-z

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  • DOI: https://doi.org/10.1007/s10549-017-4433-z

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