Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative

Simon, Michael S.; Beebe‐Dimmer, Jennifer L.; Hastert, Theresa A.; Manson, JoAnn E.; Feliciano, Elizabeth M. Cespedes; Neuhouser, Marian L.; Ho, Gloria Y.F.; Freudenheim, Jo L.; Strickler, Howard D.; Ruterbusch, Julie J.; Barac, Ana; Chlebowski, Rowan T.; Caan, Bette J.

doi:10.1002/cncr.31230

Cited by 38 publications

(49 citation statements)

References 57 publications

(143 reference statements)

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“…A recent systematic review examined the risk of CVD mortality after breast cancer, and concluded that approximately 2% to 10% of women with breast cancer die of CVD, and that CVD mortality is elevated among women with breast cancer compared with women without a breast cancer history . Similar to women in the general population, traditional risk factors for CVD, such as hypertension and excess adiposity, have been associated with CVD incidence and mortality among survivors of breast cancer . However, to our knowledge, whether breast cancer and its treatment exacerbate these risk factors, contributing to greater increases in CVD risk over time compared with among women without breast cancer, has not been well established to date.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies also have identified endocrine therapy as a predictor of weight gain in survivors of breast cancer, whereas others have not noted this association . Although to the best of our knowledge the consequences of weight gain on CVD among women with breast cancer remain unclear, and could depend on the timing of weight gain relative to the diagnosis of breast cancer, excess adiposity measured at a single time point has been positively associated with CVD incidence and mortality after breast cancer . Thus weight, BMI, and other adiposity measures remain important outcomes to monitor in women with a breast cancer history.…”

Section: Discussionmentioning

confidence: 99%

“…6 Similar to women in the general population, traditional risk factors for CVD, such as hypertension and excess adiposity, have been associated with CVD incidence and mortality among survivors of breast cancer. [11][12][13] However, to our knowledge, whether breast cancer and its treatment exacerbate these risk factors, contributing to greater increases in CVD risk over time compared with among Abbreviations: 95% CI, 95% confidence interval; BMI, body mass index; BP, blood pressure; CVD, cardiovascular disease. a Adjusted for age at enrollment, time between enrollment and second visit, and enrollment measure.…”

Section: Discussionmentioning

confidence: 99%

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Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Anderson

Nichols

Deal

et al. 2018

Cancer

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Background: Cardiovascular disease (CVD) risk is an important health concern among breast cancer survivors. However, few studies have examined whether trajectories of CVD risk and major risk factors are worse among women with a breast cancer diagnosis than those without. Methods: We compared changes in weight, body mass index (BMI), waist circumference, systolic blood pressure, and 10-year CVD risk between women with (N=813) and without (N=1049) an incident breast cancer diagnosis while enrolled in the Sister Study cohort. Blood pressure and adiposity measures were collected by trained examiners at an enrollment visit (≥1 year before breast cancer diagnosis) and a second home visit 4–11 years later (≥1 year after breast cancer diagnosis). The non-laboratory-based Framingham risk score, a measure of 10-year general CVD risk, was calculated at both the enrollment and second visits. All analyses were stratified by menopausal status at enrollment. Results: Women who were premenopausal at enrollment experienced moderate increases in weight, waist circumference, systolic blood pressure, and CVD risk over the study period. Those who were postmenopausal at enrollment had little change in weight, but increases in waist circumference, systolic blood pressure, and CVD risk. In both groups, changes over time did not differ significantly according to breast cancer status. Neither chemotherapy nor endocrine therapy were associated with greater increases in CVD risk or risk factors. Conclusions: In our cohort, changes over time in CVD risk, adiposity measures, and blood pressure were similar between women who developed an incident breast cancer and those who did not.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Anderson

Nichols

Deal

et al. 2018

Cancer

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“…Cardiovascular risk factors can be enhanced during cancer treatment and lead to an increased risk of coronary artery disease (CAD) in survivors (Chang, Moudgil, Scarabelli, Okwuosa, & Yeh, 2017a;Chang, Okwuosa, Scarabelli, Moudgil & Yeh, 2017b;Darby et al, 2013;Greenlee et al, 2017;Hague et al, 2014;Marmagkiolis et al, 2016;Weaver, Jessup, & Mayer, 2013). Increased CVD morbidity and mortality may be attributed to preexisting CVD in newly diagnosed cancer patients, cardiotoxicity resulting in decreased ventricular function, and treatment effects that result in increased CVRFs such as dyslipidemia, hypertension, central adiposity, and metabolic syndrome (Azard & Denmark-Wahnefried, 2014;Cespedes Feliciano et al, 2016;Coviello, Knobf, & Laclergue, 2013;Gristina et al, 2015;Simon et al, 2018). Genetic factors that produce variable susceptibility to both cancer treatment and toxicity may also be at play (Buzdar, Marcus, Blumenschein, & Smith, 1985;Patel, 2016;Smit, Noordam, le Cessie, Trompet, & Jukema, 2017).…”

Section: Cardiovascular and Cancer Riskmentioning

confidence: 99%

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

Coviello¹

2018

JADPRO

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Cardio-oncology is a subspecialty of cardiology. It was created to address oncology data indicating that newly developed drugs for cancer treatment were having unanticipated cardiac side effects. Cardiooncology designs primary and secondary risk strategies through surveillance as well as interventions to reduce cardiovascular risk (CVR), prevent cardiotoxicities, and manage the side effects that may occur. Rather than discuss in detail the cardiotoxicities of specific therapies or radiation, this review article will explore the interplay of cancer, cancer treatment, and CVR. It will examine the link between CVR and cancer risk, define mechanisms associated with cardiotoxicity, and describe screening and surveillance for patients undergoing cancer treatment. Finally, effective preventative and management strategies used to reduce the incidence of cardiotoxicities in those receiving chemotherapeutics or radiation will be presented.

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“…The consequence of a growing population of cancer survivors is that most will end up dying of some cause other than their cancer. Numerous studies of cancer survivors indicate that cardiovascular disease is the most common cause of mortality for patients with the 2 most common cancers diagnosed in the United States, breast cancer and prostate cancer . Studies have also shown that in comparison with individuals without cancer, breast and prostate cancer survivors actually have a greater risk of developing and dying of cardiovascular disease .…”

Section: Introductionmentioning

confidence: 99%

Physical activity and quality of life in African American cancer survivors: The Detroit Research on Cancer Survivors study

Beebe‐Dimmer

Ruterbusch

Harper

et al. 2020

Cancer

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Background The benefit of regular exercise in improving cancer outcomes is well established. The American Cancer Society (ACS) released a recommendation that cancer survivors should engage in at least 150 minutes of moderate to vigorous physical activity (PA) per week; however, few report meeting this recommendation. This study examined the patterns and correlates of meeting ACS PA recommendations in the Detroit Research on Cancer Survivors (ROCS) cohort of African American cancer survivors. Methods Detroit ROCS participants completed baseline and yearly follow‐up surveys to update their health and health behaviors, including PA. This study examined participation in PA by select characteristics and reported health‐related quality of life (HRQOL) as measured with the Functional Assessment of Cancer Therapy and Patient‐Reported Outcomes Measurement Information System instruments. Results Among the first 1500 ROCS participants, 60% reported participating in regular PA, with 24% reporting ≥150 min/wk. Although there were no differences by sex, prostate cancer survivors were the most likely to report participating in regular PA, whereas lung cancer survivors were the least likely (P = .022). Survivors who reported participating in regular PA reported higher HRQOL (P < .001) and lower depression (P = .040). Conclusions Just 24% of African American cancer survivors reported meeting the ACS guidelines for PA at the baseline, but it was encouraging to see increases in activity over time. Because of the established benefits of regular exercise observed in this study and others, identifying and reducing barriers to regular PA among African American cancer survivors are critical for improving outcomes and minimizing disparities.

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Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative

Abstract: Among women with early stage breast cancer, cardiometabolic risk factors are significantly associated with cardiovascular and other-cause mortality, but not breast cancer mortality. Cancer 2018;124:1798-807. © 2018 American Cancer Society.

Cited by 38 publications

References 57 publications

Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

Physical activity and quality of life in African American cancer survivors: The Detroit Research on Cancer Survivors study

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