Breast Cancer Research and Treatment

, Volume 145, Issue 1, pp 233–243 | Cite as

Long-term risk of medical conditions associated with breast cancer treatment

  • Deirdre A. HillEmail author
  • Nora K. Horick
  • Claudine Isaacs
  • Susan M. Domchek
  • Gail E. Tomlinson
  • Jan T. Lowery
  • Anita Y. Kinney
  • Jonathan S. Berg
  • Karen L. Edwards
  • Patricia G. Moorman
  • Sharon E. Plon
  • Louise C. Strong
  • Argyrois Ziogas
  • Constance A. Griffin
  • Carol H. Kasten
  • Dianne M. Finkelstein


Early and late effects of cancer treatment are of increasing concern with growing survivor populations, but relevant data are sparse. We sought to determine the prevalence and hazard ratio of such effects in breast cancer cases. Women with invasive breast cancer and women with no cancer history recruited for a cancer research cohort completed a mailed questionnaire at a median of 10 years post-diagnosis or matched reference year (for the women without cancer). Reported medical conditions including lymphedema, osteopenia, osteoporosis, and heart disease (congestive heart failure, myocardial infarction, coronary heart disease) were assessed in relation to breast cancer therapy and time since diagnosis using Cox regression. The proportion of women currently receiving treatment for these conditions was calculated. Study participants included 2,535 women with breast cancer and 2,428 women without cancer (response rates 66.0 % and 50.4 %, respectively) Women with breast cancer had an increased risk of lymphedema (Hazard ratio (HR) 8.6; 95 % confidence interval (CI) 6.3–11.6), osteopenia (HR 2.1; 95 % CI 1.8–2.4), and osteoporosis (HR 1.5; 95 % CI 1.2–1.9) but not heart disease, compared to women without cancer Hazard ratios varied by treatment and time since diagnosis. Overall, 49.3 % of breast cancer cases reported at least one medical condition, and at 10 or more years post-diagnosis, 37.7 % were currently receiving condition-related treatment. Responses from survivors a decade following cancer diagnosis demonstrate substantial treatment-related morbidity, and emphasize the need for continued medical surveillance and follow-up care into the second decade post-diagnosis.


Breast neoplasms Lymphedema Osteoporosis Heart disease Chemotherapy Radiotherapy 



This study was supported by grants U01CA078284, U24CA078134, U24CA078142, U24CA078146, U24CA078148, U24CA078156, U24CA078157, U24CA078164, U24CA078174; and contract HHSN2612007440000C from the National Cancer Institute.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Deirdre A. Hill
    • 1
    Email author
  • Nora K. Horick
    • 2
  • Claudine Isaacs
    • 4
  • Susan M. Domchek
    • 5
  • Gail E. Tomlinson
    • 6
  • Jan T. Lowery
    • 7
  • Anita Y. Kinney
    • 1
  • Jonathan S. Berg
    • 8
  • Karen L. Edwards
    • 9
  • Patricia G. Moorman
    • 10
  • Sharon E. Plon
    • 12
  • Louise C. Strong
    • 11
  • Argyrois Ziogas
    • 13
  • Constance A. Griffin
    • 14
  • Carol H. Kasten
    • 15
  • Dianne M. Finkelstein
    • 3
  1. 1.Department of Internal Medicine and Cancer Research and Treatment CenterUniversity of New MexicoAlbuquerqueUSA
  2. 2.Massachusetts General Hospital Biostatistics CenterBostonUSA
  3. 3.Harvard UniversityBostonUSA
  4. 4.Department of Medicine and the Lombardi Comprehensive Cancer CenterGeorgetown UniversityWashingtonUSA
  5. 5.Basser Research Center, Abramson Cancer CenterUniversity of PennsylvaniaPhiladelphiaUSA
  6. 6.Department of Hematology/OncologyUniversity of Texas Health Science CenterDallasUSA
  7. 7.Department of Epidemiology, School of Public HealthUniversity of ColoradoDenverUSA
  8. 8.Departments of Genetics and Internal Medicine/Hematology-Oncology and the Lineberger Comprehensive Cancer CenterUniversity of North Carolina School of MedicineChapel HillUSA
  9. 9.Department of Epidemiology and the Institute for Public Health Genetics, School of Public HealthUniversity of WashingtonSeattleUSA
  10. 10.Department of Community and Family Medicine and Cancer Prevention, Detection and Control Research ProgramDuke University Medical CenterDurhamUSA
  11. 11.Department of GeneticsUniversity of Texas M. D. Anderson Cancer CenterHoustonUSA
  12. 12.Departments of Pediatrics and Molecular and Human GeneticsBaylor College of MedicineHoustonUSA
  13. 13.Department of EpidemiologyUniversity of California, IrvineIrvineUSA
  14. 14.Departments of Pathology and OncologyJohns Hopkins School of MedicineBaltimoreUSA
  15. 15.Food and Drug AdministrationU.S. Department of Health and Human ServicesSilver SpringUSA

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