Breast Cancer Research and Treatment

, Volume 131, Issue 3, pp 907–914

Comparison of breast cancer recurrence risk and cardiovascular disease incidence risk among postmenopausal women with breast cancer

Authors

  • Aditya Bardia
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
    • Massachusetts General Hospital Cancer Center
  • Erin T. Arieas
    • Division of Cardiology, Department of MedicineJohns Hopkins School of Medicine
    • Mercy Medical Group, A Service of Catholic Healthcare West (CHW)Medical Foundation Internal Medicine
  • Zhe Zhang
    • Division of Biostatistics and Bioinformatics, Department of OncologyJohns Hopkins School of Medicine
  • Andrew DeFilippis
    • Division of Cardiology, Department of MedicineJohns Hopkins School of Medicine
  • Karineh Tarpinian
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
  • Stacie Jeter
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
  • Anne Nguyen
    • Department of Medicine, Melvin and Bren Simon Cancer CenterIndiana University
  • N. Lynn Henry
    • Breast Oncology Program, University of Michigan Comprehensive Cancer Center
  • David A. Flockhart
    • Department of Medicine, Melvin and Bren Simon Cancer CenterIndiana University
  • Daniel F. Hayes
    • Breast Oncology Program, University of Michigan Comprehensive Cancer Center
  • Jill Hayden
    • Breast Oncology Program, University of Michigan Comprehensive Cancer Center
  • Anna Maria Storniolo
    • Department of Medicine, Melvin and Bren Simon Cancer CenterIndiana University
  • Deborah K. Armstrong
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
  • Nancy E. Davidson
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
    • University of Pittsburgh Cancer Institute and UPMC Cancer Center
  • John Fetting
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
  • Pamela Ouyang
    • Division of Cardiology, Department of MedicineJohns Hopkins School of Medicine
  • Antonio C. Wolff
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
  • Roger S. Blumenthal
    • Division of Cardiology, Department of MedicineJohns Hopkins School of Medicine
  • M. Dominique Ashen
    • Division of Cardiology, Department of MedicineJohns Hopkins School of Medicine
    • Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins School of Medicine
Clinical trial

DOI: 10.1007/s10549-011-1843-1

Cite this article as:
Bardia, A., Arieas, E.T., Zhang, Z. et al. Breast Cancer Res Treat (2012) 131: 907. doi:10.1007/s10549-011-1843-1

Abstract

The majority of breast cancers are diagnosed in postmenopausal women. Competing comorbidities, particularly cardiovascular disease (CVD), should be considered when individualizing adjuvant therapies for these women. We compared the 10-year predicted breast cancer recurrence risk with CVD risk among postmenopausal women with hormone receptor-positive (HR+), non-metastatic breast cancer. CVD risk factor data were prospectively collected from postmenopausal women with stage I-III, HR+ breast cancer initiating adjuvant aromatase inhibitor therapy. We compared predicted 10-year CVD risk, including the composite index heart age, computed from modified Framingham risk score, with predicted 10-year risk of breast cancer recurrence using Adjuvant! Online. We created multivariable logistic regression models to estimate the odds ratios (OR) and 95% confidence intervals (CI) for greater CVD risk than breast cancer recurrence risk. Among 415 women, mean age and heart age were 60 and 67 years, respectively. Overall, 43% of women had a predicted 10-year CVD risk equivalent to breast cancer recurrence risk and 37% had CVD risk higher than breast cancer recurrence risk. Predicted CVD risk was higher than breast cancer recurrence risk for stage I disease (OR: 6.1, 95% CI: 3.4–11.2) or heart age >65 (OR: 12.4, 95% CI: 7.0–22.6). The majority of postmenopausal women with HR+ early breast cancer had a predicted 10-year CVD risk that was equivalent to or higher than breast cancer recurrence risk. Physicians should weigh competing risks and offer early screening and cardiac prevention strategies for women at a greater risk for CVD.

Keywords

Breast cancer riskCardiovascular disease riskAdjuvant! OnlineModified Framingham risk scoreCancer survivorship

Copyright information

© Springer Science+Business Media, LLC. 2011