Heart disease is biggest killer among older breast cancer survivors
MedWire News: Older women with breast cancer are now more likely to die from heart disease than from cancer, an analysis of US registry data indicates.
The study underscores the importance of maintaining cardiovascular risk-factor control among breast cancer survivors, say Jennifer Patnaik (University of Colorado Denver, USA) and team in Breast Cancer Research.
Patnaik's team used the Surveillance, Epidemiology and End Results (SEER) database to identify women aged 66 years and above who were diagnosed with primary breast cancer between 1992 and 2000.
A total of 63,566 women were included in the study. Long-term follow-up data on each woman was obtained from a linked Medicare database. The median duration of follow-up was 8.75 years, during which time 51.3% of the cohort died.
Overall, 15.9% of the population died from cardiovascular disease, 15.1% died from breast cancer, and 20.3% died from other causes. The median age at death was 83 years.
In multivariate analysis, significant baseline predictors for breast cancer mortality were higher tumor stage, higher tumor grade, endocrine receptor-negative status, Black ethnicity, and comorbidities (such as previous cancer, chronic obstructive pulmonary disease, and cardiovascular disease).
"The finding that comorbidities had a significant effect on breast cancer-specific mortality is new and of particular interest," remark Patnaik et al.
Meanwhile, baseline predictors for death from non-cancer causes were older age, higher tumor stage, and comorbidities.
The distribution of causes of death varied by age and tumor stage, such that women with lower-stage cancers were most likely to die from cardiovascular disease, whereas those with higher-stage cancers were most likely die from breast cancer.
The researchers conclude: "Underdiagnosis and undertreatment of cardiovascular disease may be important issues for women diagnosed with cancer, as their cancer diagnosis can be perceived by both the patient and her caregivers as the overriding medical priority.
They add: "Especially among older breast cancer survivors, risk management of factors associated with cardiovascular disease can help improve overall survival."
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By Joanna Lyford