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

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

Abstract

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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Internal Medicine and Cancer Research and Treatment Center, University of New Mexico, MSC 10-5550, Albuquerque, NM, 87131-0001, USA

    Deirdre A. Hill & Anita Y. Kinney

  2. Massachusetts General Hospital Biostatistics Center, Boston, MA, USA

    Nora K. Horick

  3. Harvard University, Boston, MA, USA

    Dianne M. Finkelstein

  4. Department of Medicine and the Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

    Claudine Isaacs

  5. Basser Research Center, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA

    Susan M. Domchek

  6. Department of Hematology/Oncology, University of Texas Health Science Center, San Antonio, and Southwestern Medical Center, Dallas, TX, USA

    Gail E. Tomlinson

  7. Department of Epidemiology, School of Public Health, University of Colorado, Denver, USA

    Jan T. Lowery

  8. Departments of Genetics and Internal Medicine/Hematology-Oncology and the Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Jonathan S. Berg

  9. Department of Epidemiology and the Institute for Public Health Genetics, School of Public Health, University of Washington, Seattle, WA, USA

    Karen L. Edwards

  10. Department of Community and Family Medicine and Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC, USA

    Patricia G. Moorman

  11. Department of Genetics, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Louise C. Strong

  12. Departments of Pediatrics and Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA

    Sharon E. Plon

  13. Department of Epidemiology, University of California, Irvine, Irvine, CA, USA

    Argyrois Ziogas

  14. Departments of Pathology and Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Constance A. Griffin

  15. Food and Drug Administration, U.S. Department of Health and Human Services, Silver Spring, MD, USA

    Carol H. Kasten

Authors
  1. Deirdre A. Hill
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  2. Nora K. Horick
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  3. Claudine Isaacs
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Correspondence to Deirdre A. Hill.

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For the Cancer Genetics Network.

Constance A. Griffin Deceased.

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Hill, D.A., Horick, N.K., Isaacs, C. et al. Long-term risk of medical conditions associated with breast cancer treatment. Breast Cancer Res Treat 145, 233–243 (2014). https://doi.org/10.1007/s10549-014-2928-4

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