title: Comparison of breast cancer recurrence risk and cardiovascular disease incidence risk among postmenopausal women with breast cancer.
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.
authors: Breast Cancer Program, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Bunting-Blaustein Cancer Research Building 1, Room 144, 1650 Orleans Street, Baltimore, MD 21231, USA.
authors: Aditya
authors: A
authors: Bardia
authors: Erin T
authors: ET
authors: Arieas
authors: Zhe
authors: Z
authors: Zhang
authors: Andrew
authors: A
authors: Defilippis
authors: Karineh
authors: K
authors: Tarpinian
authors: Stacie
authors: S
authors: Jeter
authors: Anne
authors: A
authors: Nguyen
authors: N Lynn
authors: NL
authors: Henry
authors: David A
authors: DA
authors: Flockhart
authors: Daniel F
authors: DF
authors: Hayes
authors: Jill
authors: J
authors: Hayden
authors: Anna Maria
authors: AM
authors: Storniolo
authors: Deborah K
authors: DK
authors: Armstrong
authors: Nancy E
authors: NE
authors: Davidson
authors: John
authors: J
authors: Fetting
authors: Pamela
authors: P
authors: Ouyang
authors: Antonio C
authors: AC
authors: Wolff
authors: Roger S
authors: RS
authors: Blumenthal
authors: M Dominique
authors: MD
authors: Ashen
authors: Vered
authors: V
authors: Stearns
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D017698:Postmenopause; D011379:Prognosis
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors