Each cardiovascular disease risk factor (CVD-RFs) identified among patients with breast cancer increases the risk of cardiac events and mortality, according to a study published in the Journal of Clinical Oncology.

With advancements in the treatment of women with breast cancer, cardiovascular events have replaced cancer-specific mortality as the leading cause of death in this population. The association between long-term cardiac events and CVD-RFs among patients with breast cancer requires further investigation.

For this study, researchers assessed the outcomes of 1460 elderly patients (older than 66) from the SWOG breast cancer trials with baseline comorbid conditions associated with CVD, including diabetes, obesity, hypertension, hypercholesterolemia, and coronary artery disease or ischemic heart disease.

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Of 842 patients evaluable for survival outcomes analysis, hypertension and hypercholesterolemia were the most commonly observed, and occurred in 73% and 57% of patients, respectively. Overall, 87% of patients had at least one CVD-RF.

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After a median follow-up of 6 years, no association was found between individual CVD-RFs and overall survival (OS); only hypercholesterolemia was associated with an improved OS. Results showed however, that the risk of death, progression-free survival, and cancer-free survival all were negatively affected with each additional CVD-RF identified. A strong correlation between the number of CVD-RFs and cardiac events was identified after further analysis was conducted in 736 patients.

The authors concluded that “efforts to improve control of modifiable CVD-RFs are needed, especially among those with multiple risk factors.”


Hershman DL, Till C, Shen S, et al. Association of cardiovascular risk factors with cardiac events and survival outcomes among patients with breast cancer enrolled in SWOG clinical trials [published online March 27, 2018].  J Clin Oncol. doi: 10.1200/JCO.2017.77.4414