Preoperative Lymphedema-Related Risk Factors in Early-Stage Breast Cancer

2018 ◽  
Vol 16 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Zeynep Erdogan Iyigun ◽  
Tomris Duymaz ◽  
Ahmet Serkan Ilgun ◽  
Gul Alco ◽  
Cetin Ordu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Related Risk

Cardiovascular risk profile of breast cancer patients treated with anthracycline-taxane containing adjuvant chemotherapy and/or trastuzumab

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 666-666 ◽  
Author(s):  
L. W. Jones ◽  
M. Haykowsky ◽  
C. J. Peddle ◽  
A. A. Joy ◽  
E. N. Pituskin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Sinus Tachycardia ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Cvd Risk Factors ◽  
Cvd Risk

666 Background: With improving longevity, post-treatment cardiovascular disorders will become an increasingly important indicator of competing mortality in early-stage breast cancer. As such, we conducted a pilot study to comprehensively evaluate the CVD profile of a subset of early-stage breast cancer patients treated with adjuvant taxane-anthracycline containing chemotherapy and/or trastuzumab. Methods: Twenty-six breast cancer patients (mean 20 months post chemotherapy) who participated in Breast Cancer International Research Group 006 clinical trial and 10 healthy age-matched women were studied. We measured 14 metabolic and vascular established CVD risk factors, BMI, VO2peak and left ventricular systolic function. All assessments were performed within a 14-day period. Results: Cardiac abnormalities were suggested by LVEF <50% in 10% of patients, LVEF remained >10% below pre-treatment values in 38% while 50% presented with resting sinus tachycardia. BNP was significantly elevated in 40% and was correlated with LVEF (r = -0.72, p=<.001). For the majority of CVD risk factors, similar proportions of patients and controls (35% to 60%) were classified as ‘undesirable.’ A significantly higher proportion of patients were classified with low VO2peak (46% vs. 0%, p<0.01), being overweight/obese (72% vs. 50%, p<0.05), and having resting sinus tachycardia (50% vs. 0%, p<0.01) compared with controls. VO2peak and BMI were correlated with CV risk factors (r = -0.64 to 0.63, p<0.05; r = -0.63 to 0.67, p<0.05, respectively). Exploratory analyses revealed several differences between CVD risk factors based on chemotherapy regimen. Conclusions: Breast cancer survivors treated with adjuvant chemotherapy are at a higher risk of developing late-occurring CVD than age matched controls due to direct and indirect treatment-related toxicity. No significant financial relationships to disclose.

Predictors of permanent menopause after chemotherapy for early-stage breast cancer in premenopausal women

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 575-575
Author(s):  
H. C. Moore ◽  
J. Kim ◽  
C. Rodriguez ◽  
G. T. Budd ◽  
L. Rybicki
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Endocrine Therapy ◽  
Early Stage ◽  
Menopausal Status ◽  
Early Stage Breast Cancer ◽  
Smoking History ◽  
Age At Menarche ◽  
Premenopausal Breast Cancer ◽  
Additional Risk

575 Background: Optimal choice of endocrine therapy for early-stage breast cancer differs with menopausal status. While amenorrhea is common during adjuvant chemotherapy, there is currently no available test to establish when menopause is permanent. The aim of this study was to determine the age cutoff after which resumption of menses is unlikely following chemotherapy and to assess what additional risk factors may predict for persistent menopause at 5 years after initiation of chemotherapy. Methods: One hundred patients treated with chemotherapy for early-stage premenopausal breast cancer and who remained alive and free of recurrence at least 5 years from the start of treatment were enrolled. Participants were evaluated for current menstrual status and for baseline potential risk factors for menopause: age at start of chemotherapy, race, BMI, smoking history, age at menarche, irregular menses prior to chemotherapy, presence of menses during chemotherapy, type of chemotherapy regimen, hormonal therapy, ovarian protection during chemotherapy, and number of doses of alkylating agent (cyclophosphamide). Recursive partitioning analysis (RPA) was used to identify the age cutoff that best predicts permanent menopause; additional risk factors were assessed using logistic regression analysis. Results: Median age at start of chemotherapy was 43 (range 26–49). RPA identified age >42 at the start of chemotherapy as a significant predictor of permanent menopause (p < 0.001). Cessation of menses during chemotherapy was also associated with permanent menopause (p < 0.001). Both variables remained significant in multivariate analysis (p < 0.001), with the combination of these factors being associated with a 95.4% chance of permanent menopause. Conclusions: In this series, fewer than 5% of premenopausal patients who were at least 42 years old and who experienced cessation of menses during chemotherapy experienced any return of menses over at least 5 years. Upfront use of aromatase inhibitors as adjuvant endocrine therapy for premenopausal hormone-receptor positive breast cancer warrants further investigation for those who are at least 42 years of age and who experience amenorrhea with chemotherapy. No significant financial relationships to disclose.

Risk-Imaging Mismatch in Cardiac Imaging Practices for Women Receiving Systemic Therapy for Early-Stage Breast Cancer: A Population-Based Cohort Study

2018 ◽  
Vol 36 (30) ◽  
pp. 2980-2987 ◽  
Author(s):  
Paaladinesh Thavendiranathan ◽  
Husam Abdel-Qadir ◽  
Hadas D. Fischer ◽  
Ying Liu ◽  
Ximena Camacho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Cardiac Imaging ◽  
Chemotherapy Regimen ◽  
Early Stage ◽  
Population Based ◽  
Early Stage Breast Cancer ◽  
Patient Specific

PurposeTo assess prechemotherapy cardiac imaging practices in relation to patients’ heart failure (HF) risk.MethodsWe performed a population-based retrospective cohort study of women receiving chemotherapy for early-stage breast cancer in Ontario between 2007 and 2012. We surveyed for baseline cardiac imaging 6 months before chemotherapy or within 30 days thereafter. The proportion of patients who underwent imaging and cumulative incidence of major adverse cardiac event (MACE) rates was determined based on chemotherapy regimen and HF risk factors. Logistic regression was used to assess predictors of pretreatment cardiac imaging.ResultsWe studied 18,444 women who had been treated with chemotherapy (median age, 55 years). There was near-universal imaging of women treated with trastuzumab-containing regimens, including those without additional HF risk factors. Women who received anthracyclines without trastuzumab underwent imaging more frequently if they had additional HF risk factors (73.3% v 62.6%; P < .001). The 5-year incidence of MACE was two to six times higher in patients with HF risk factors across all treatment regimens. Patients with HF risk factors who received anthracyclines without trastuzumab had a higher 5-year incidence of MACE (4.5%) than patients without HF risk factors who received trastuzumab without anthracyclines (2.6%). However, cardiac imaging was less frequent in the former group (73.3% v 93.6%; P < .001). Logistic regression indicated that most variation in baseline imaging was related to chemotherapy, followed by physician-level factors. The odds of imaging were doubled with female physicians. Patient-specific factors, including HF risk factors, made minimal contribution to variation in imaging.ConclusionBaseline cardiac imaging was driven by chemotherapy regimen rather than HF risk. This risk-imaging mismatch is an impetus to reconsider current cardiac imaging practices in patients who receive chemotherapy for breast cancer.

scholarly journals The Risk of Heart Failure and Other Cardiovascular Hospitalizations After Early Stage Breast Cancer: A Matched Cohort Study

2019 ◽  
Vol 111 (8) ◽  
pp. 854-862 ◽  
Author(s):  
Husam Abdel-Qadir ◽  
Paaladinesh Thavendiranathan ◽  
Peter C Austin ◽  
Douglas S Lee ◽  
Eitan Amir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Heart Failure ◽  
Cohort Study ◽  
Early Stage ◽  
Statistical Tests ◽  
Population Based ◽  
Emergency Department Visits ◽  
Early Stage Breast Cancer ◽  
Control Subjects

AbstractBackgroundData are limited regarding the risk of heart failure (HF) requiring hospital-based care after early stage breast cancer (EBC) and its relationship to other types of cardiovascular disease (CVD).MethodsWe conducted a population-based, retrospective cohort study of EBC patients (diagnosed April 1, 2005–March 31, 2015) matched 1:3 on birth-year to cancer-free control subjects. We identified hospitalizations and emergency department visits for CVD through March 31, 2017. We used cumulative incidence function curves to estimate CVD incidence and cause-specific regression models to compare CVD rates between cohorts. All statistical tests were two-sided.ResultsWe identified 78 318 EBC patients and 234 954 control subjects. The 10-year incidence of CVD hospitalization was 10.8% (95% confidence interval [CI] = 10.5% to 11.1%) after EBC and 9.1% (95% CI = 8.9% to 9.2%) in control subjects. Ischemic heart disease was the most common reason for CVD hospitalization after EBC. After regression adjustment, the relative rates compared with control subjects remained statistically significantly elevated for HF (hazard ratio [HR] = 1.21, 95% CI = 1.14 to 1.29, P < .001), arrhythmias (HR = 1.31, 95% CI = 1.23 to 1.39, P < .001), and cerebrovascular disease (HR 1.10, 95% CI = 1.04 to 1.17, P = .002) hospitalizations. It was rare for HF hospital presentations (2.9% of cases) to occur in EBC patients without recognized risk factors (age >60 years, hypertension, diabetes, prior CVD). Anthracycline and/or trastuzumab were used in 28 950 EBC patients; they were younger than the overall cohort with lower absolute rates of CVD, hypertension, and diabetes. However, they had higher relative rates of CVD in comparison with age-matched control subjects.ConclusionsAtherosclerotic diagnoses, rather than HF, were the most common reasons for CVD hospitalization after EBC. HF hospital presentations were often preceded by risk factors other than chemotherapy, suggesting potential opportunities for prevention.

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