Cardiovascular diseases are one of the late effects of breast cancer treatment that can impair survival. We reviewed the development of cardiac disease in breast cancer survivor using nationwide database.
A nation-wide retrospective cohort study was conducted using National Health Information Database which provides a whole set of claimed medical information, such as ICD-10 diagnosis and prescription data. We performed 1:5 age-sex matching with the non-cancer controls. Incidence of MI and CHF was evaluated for adjuvant treatment modalities, with adjustment of age and previous comorbidities (diabetes, hypertension, and hyperlipidemia).
A total of 112,058 cases (554,801 person-years) and 560,290 controls (2,916,459 person-years) were evaluated. Risk of MI (hazard ratio (HR) 1.258, 95% confidence interval (CI) 1.168 - 1.355) and CHF (HR 1.86, 95% CI 1.753 – 1.973) was higher in breast cancer survivors than in non-cancer controls. Younger survivors (age 50 or less) showed the highest risk of MI (HR 1.73, 95% CI 1.512 – 1.979) and CHF (HR 3.557, 95% CI 3.174 – 3.986). Within one year of breast cancer diagnosis, the cumulative incidences of MI and CHF were significantly high in survivors. The cumulative incidence of CHF in breast cancer survivors was continuously higher than the control group, in contrast to that of MI showed similar pattern to controls. Taxane use was associated with development of MI (HR 1.284, 95% CI 1.074 – 1.534) and CHF (HR 1.65, 95% CI 1.444 – 1.887).
Incidence of MI and CHF were higher in breast cancer survivor than the non-cancer controls. The elevated risk of MI and CHF in early phase of survivorship should be noted, especially in young age group.
The Study of Multi-disciplinary Teamwork for breast cancer survivorship (SMARTSHIP).
Korean Breast Cancer Society.
The authors appreciate to the Korean Breast Cancer Society and the Study of Multi-dicsiplinary Teamwork for breast cancer survivorship (SMARTSHIP)
All authors have declared no conflicts of interest.