title: Breast cancer therapy and age difference in cardiovascular disease risks: A population-based cohort study in Taiwan.
abstract: OBJECTIVE
  Cardiovascular events induced in breast cancer patients receiving radiotherapy (RT), chemotherapy (CT), or a combination of both (CRT) can increase the risk of death. This nationwide population-based study aims to estimate the risk of cardiovascular complications with a follow-up period of 5 years.
  
  
  METHODS
  The study cohorts consisted of all patients hospitalized with a principal diagnosis of breast cancer who underwent treatment in 2002. The Cox proportional hazard model and Kaplan-Meier plot were analyzed to compare the cardiovascular event-free survival rate among breast cancer patients treated with different modalities.
  
  
  RESULTS
  Of the 5514 breast cancer patients identified, 289 patients had cardiovascular disease (CVD): 110 (5.7%) from the surgery-alone group, 24 (4.1%) from the RT group, 79 (4.6) from the CT group, and 76 (5.8%) from the CRT group. Breast cancer patients who undergo CT and CRT at an age less than 55 years had a higher risk of CVD when compared with the surgery-alone group (for both groups, p < 0.001). By contrast, breast cancer patients aged over 55 years had no increased risk of CVD among the different treatment modalities.
  
  
  CONCLUSIONS
  Breast cancer patients receiving CT and/or CRT have a higher risk of CVD, especially younger patients (aged < 55 years). Therefore, regular examinations of cardiac functions and electrocardiogram should be considered in cases of young breast cancer patients who are receiving CT and/or CRT.
authors.affiliation: Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Chen Hui
authors.initials: CH
authors.lastname: Tan
authors.affiliation: Medical Research Center, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Chao
authors.affiliation: Division of Neurology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors.forename: Jui-Chen
authors.initials: JC
authors.lastname: Liu
authors.affiliation: Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Division of Neurology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Yung-Sung
authors.initials: YS
authors.lastname: Huang
authors.affiliation: Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Chung-Ming
authors.initials: CM
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Hon-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Su
authors.affiliation: Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. Electronic address: anthonypatho@gmail.com.
authors.forename: Yen-Lin
authors.initials: YL
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan. Electronic address: hematcd2@hotamil.com.
authors.forename: Ching-Chih
authors.initials: CC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008408:Mastectomy; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D013624:Taiwan / Q000453:epidemiology
keywords: breast cancer; cardiovascular disease; chemotherapy; radiotherapy