Women with advanced or metastatic breast cancer at diagnosis are more likely to have pre-existing cardiovascular disease, versus those with early-stage cancer.
Summary: A study from The University of Texas MD Anderson Cancer Center found that women diagnosed with advanced or metastatic breast cancer are more likely to have pre-existing cardiovascular disease compared to those with early-stage breast cancer. The study, published in JAMA Network Open, revealed that individuals with cardiovascular disease were 10% more likely to be diagnosed with advanced breast cancer, particularly those with the hormone receptor-positive (HR+) and HER2-negative (HER2-) subtype. The findings suggest a potential connection between cardiovascular disease and the progression of breast cancer, highlighting the importance of personalized screening strategies for early detection.
Key Takeaways:
- Link Between Cardiovascular Disease and Advanced Breast Cancer: Women with pre-existing cardiovascular disease are at a higher risk of being diagnosed with advanced or metastatic breast cancer, particularly the HR+/HER2- subtype.
- Potential Screening Implications: The findings suggest that women with cardiovascular disease may benefit from more frequent or earlier breast cancer screenings to detect the disease at a more treatable stage.
- Increased Risk in Older Patients: The study, which included women with a median age of 73, shows a statistically significant increased risk of cardiovascular disease in those diagnosed with later-stage breast cancer.
According to researchers from The University of Texas MD Anderson Cancer Center, patients diagnosed with late-stage or metastatic breast cancer have a statistically significant increased risk of pre-diagnosis cardiovascular disease compared to those with early-stage cancer at diagnosis.
The study, published in JAMA Network Open, found those with advanced breast cancer at diagnosis were 10% more likely to have had pre-existing cardiovascular disease. Additionally, the data revealed patients with a specific breast cancer subtype, hormone receptor-positive (HR+) and HER2-negative (HER2-), were most likely to have pre-existing cardiovascular disease (11%).
“Cardiovascular disease can induce an immunosuppressive state, potentially fostering accelerated breast tumor cell growth and spread,” says senior author Kevin Nead, MD, assistant professor of epidemiology and radiation oncology, in a release. “Our findings suggest that women with cardiovascular disease may be more likely to be diagnosed with advanced breast cancer, highlighting a potential connection between the two.”
Study Design and Key Findings
The case-control study looked at data from more than 19,000 women with a median age of 73 and compared the presence of cardiovascular disease between patients with early (stage I-II) and advanced cancer (stage III-IV). The increased risk was present both for patients with locally advanced and metastatic breast cancer.
According to the National Cancer Institute, HR+/HER2− breast cancer constitutes nearly 70% of all breast cancer cases. When caught at an early stage, before it metastasizes, the disease is very treatable. However, the five-year relative survival rate for metastatic HR+/ HER2- breast cancer is only 34%, underscoring the need for prevention and early detection.
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Cardiovascular disease is the cause of nearly one million deaths in the U.S. annually. This class of conditions can include coronary heart disease, stroke, high blood pressure, heart failure, hypertension, and arterial disease.
Of those women included in the study, 49% were found to have cardiovascular disease. The cohort was pulled from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases from 2009-2020. The analysis was completed from May 2023 to August 2024.
“The study could help inform personalized screening strategies, as it suggests that individuals with [cardiovascular disease] may benefit from earlier or more frequent breast cancer screenings to catch the disease at an earlier, more treatable stage,” Nead says in a release.
Limitations of the study include the fact that it was observational and does not demonstrate causality, susceptibility to residual bias, potential for misclassification of cardiovascular disease, and lack of control for potential compounding factors, including smoking. The cohort was primarily white, which may also impact the generalizability of the findings.
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