Patients with breast cancer do not have a higher incidence of heart-specific mortality compared with the general population, according to a study published in the European Heart Journal.

Although advances in breast cancer treatment have improved survival outcomes among this patient population, long-term mortality attributed to cardiac toxicity and disease is a significant concern. Evidence from recent studies have suggested that the cumulative mortality from cardiovascular disease surpasses that of breast cancer, but results were drawn from breast cancer cohorts and have not been tested against the general population.

For this retrospective cohort study, researchers accessed the Surveillance, Epidemiology, and End Results-18 (SEER-18) database to assess the results of 347,476 patients with breast cancer diagnosed between 2000 and 2011 and treated with radiotherapy or chemotherapy. Crude cumulative mortality functions were computed, and long-term standardized mortality ratios (SMRs) were calculated to compare heart-specific mortality among survivors with that of the general population.

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Results showed that breast cancer was the leading cause of cumulative mortality, and even despite receiving radiotherapy or chemotherapy, patients with breast cancer had lower heart-specific mortality compared with the general population.

A subgroup analysis also revealed that patients with human epidermal growth factor receptor 2 (HER2)-positive disease did not have an increased risk of heart-specific mortality vs patients with HER2-negative disease.

The authors concluded that “the heart-specific mortality among breast cancer patients treated with radiotherapy or chemotherapy is not increased and rather comparable with the general female population. Further studies with more detailed data on treatment are strongly desirable and needed to both validate the results presented in this study and further examine potential prognostic factors.”

Reference

Weberpals J, Jansen L, Muller OJ, Brenner H. Long-term heart-specific mortality among 347,476 breast cancer patients treated with radiotherapy or chemotherapy: a registry-based cohort study [published online April 9, 2018]. Eur Heart J. doi: 10.1093/eurheartj/ehy167