Racial disparities in treatment-related cardiovascular toxicities amongst women with breast cancer: a scoping review

Sutton, Arnethea L.; Felix, Ashley S.; Wahl, Stacey; Franco, R. Lee; Leicht, Zachary; Williams, Karen Patricia; Hundley, W. Gregory; Sheppard, Vanessa B.

doi:10.1007/s11764-022-01210-2

Cited by 4 publications

(3 citation statements)

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“…The disproportionately increased risk for hypertension among Black cancer survivors may contribute to the well described disparities in cardiovascular outcomes after cancer diagnosis. 15,16 Similar to previous studies, we found that after controlling for traditional hypertension risk factors, Black breast cancer survivors had a higher prevalence of hypertension than White survivors at the time of their breast cancer diagnosis. 17,18 Our study further contributes to the literature by examining the rates of hypertension development in previously normotensive women after a breast cancer diagnosis.…”

Section: Discussionsupporting

confidence: 88%

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Examining hypertension risk among Black and White breast cancer survivors

Sutton,

He,

Bottinor

et al. 2024

Cancer Medicine

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PurposeBreast cancer survivors are at increased risk of cardiovascular dysfunction following their diagnosis; however, hypertension remains underexplored within this context. This retrospective cohort study examined the incidence of hypertension in breast cancer survivors and the association of race with hypertension risk among them.MethodsData for this study were abstracted from the electronic health records of women diagnosed with Stages I–III breast cancer. Incident hypertension diagnosis was identified through International Classification of Diseases codes. Bivariate associations were tested using Student's t‐test and chi‐squared test of independence. Bivariable Cox regression analysis was used to determine demographic and clinical factors that may have been associated with the development of hypertension.ResultsA total of 664 women were included. Most women were 50 years of age or younger (52.0%), White (33.0% Black), and received a mastectomy (80.6%). Overall, 45.5% of the cohort developed hypertension. The 1‐year hypertension‐free survival estimates were 47% (95% confidence interval [CI], 41–54) in Black women and 73% (95% CI, 69–77) in White women (p < 0.0001). Besides race, statistically significant predictors of hypertension included: age greater than 50 (vs. ≤50) (adjusted Hazard Ratio [HR]: 1.40; 95% CI, 1.09–1.80) and residing in a non‐metropolitan area (vs. metropolitan) (adjusted HR: 1.60; 95% CI, 1.19–2.16).ConclusionsThis study suggests that breast cancer survivors who are older, Black, or residing in non‐metropolitan areas may benefit from added surveillance and hypertension prevention strategies during treatment. Future studies are needed to identify contributors to the observed racial and geographic disparities.

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Section: Discussionsupporting

confidence: 88%

“…Living in a non‐metropolitan area (vs. a metropolitan area) was associated with increased risk of hypertension. The disproportionately increased risk for hypertension among Black cancer survivors may contribute to the well described disparities in cardiovascular outcomes after cancer diagnosis 15,16 …”

Section: Discussionmentioning

confidence: 99%

Examining hypertension risk among Black and White breast cancer survivors

Sutton,

He,

Bottinor

et al. 2024

Cancer Medicine

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“…While the routine gynecologic visits for breast cancer survivors may not necessarily differ for those of the Black community, there are certain considerations that practitioners should appreciate (particularly for those gynecologists who may also serve as the patient’s sole primary care provider). For instance, Black people are more likely to experience cardiovascular toxicity from breast cancer treatments such as left-sided radiation therapy, chemotherapeutic agents such as anthracyclines, and targeted drug therapies such as trastuzumab [ 42 – 44 ]. Moreover, early-onset breast cancer diagnoses (for which Black people are at increased risk) may require oophorectomy for ovarian ablation in certain instances or may undergo chemotherapy which could lead to premature ovarian failure.…”

Section: Routine Gynecologic Carementioning

confidence: 99%

Gynecologic Care of Black Breast Cancer Survivors

Pleasant

2024

Curr Breast Cancer Rep

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Purpose of Review Black patients suffer from breast cancer-related racial health disparities, which could have implications on their gynecologic care. This review explores considerations in the gynecologic care of Black breast cancer survivors. Recent Findings Black people have a higher risk of leiomyoma and endometrial cancer, which could confound bleeding patterns such as in the setting of tamoxifen use. As Black people are more likely to have early-onset breast cancer, this may have implications on long-term bone and heart health. Black patients may be more likely to have menopausal symptoms at baseline and as a result of breast cancer treatment. Furthermore, Black patients are less likely to utilize assisted reproductive technology and genetic testing services. Summary It is important for healthcare providers to be well-versed in the intersections of breast cancer and gynecologic care. Black breast cancer survivors may have unique considerations for which practitioners should be knowledgeable.

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