Breast cancer treatments increase the risk of heart disease, warns the AHA

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By Kate Bass BScFebruary 2, 2018

The American Heart Association (AHA) recently published a statement highlighting the need to monitor cardiovascular health in women receiving treatment for breast cancer.

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The publication explores the shared risk factors for breast cancer and cardiovascular disease and the cardiotoxic effects of breast cancer treatments.

It goes on to recommend strategies to minimise the risk of cardiovascular disease in patients with breast cancer.

Cardiovascular disease is the leading cause of mortality in women, accounting for 1 in 3 deaths. However, the risk of developing breast cancer, which causes 1 in 32 deaths, receives considerably more attention amongst the general population. The risk for both disorders increases with age, particularly after the onset of menopause.

Heart disease and breast cancer share common risk factors such as age, sedentary lifestyle and smoking...More importantly, we see that many of the same things that improve heart health (healthy diet, healthy weight, exercise, not smoking) can also reduce a woman's risk for breast cancer."
Dr Laxmi Mehta, Cardiologist at The Ohio State University Ross Heart Hospital

Furthermore, some treatments used in patients with breast cancer can have a negative impact on cardiovascular health. Left ventricular systolic dysfunction, arrhythmias and QT interval prolongation are the most common cardiovascular side effects of breast cancer therapies.

With earlier detection and improved treatments, long-term survival among women who develop breast cancer is good. Older postmenopausal breast cancer survivors are now more likely to die of diseases other than breast cancer, and cardiovascular disease is the most common cause of death.

Furthermore, women who have had breast cancer are more likely to die from cardiovascular disease than women without a history of breast cancer.

The new scientific statement comes after the release of a compilation of prevalence data and shared risk factors for heart disease and breast cancer, as well as the cardiotoxic effects of cancer therapy.

It highlights the need to prevent and treat heart disease in patients with breast cancer and emphasises the importance of cardiologists and oncologists working together to optimise the health of cancer patients.

If a patient presenting with cancer has a pre-existing heart conditions, this may determine which cancer treatment is used. Similarly, the effects of cancer therapy on the heart must also be monitored and cancer treatment plans amended if a negative impact is apparent.

Some studies have already indicated that administering chemotherapy agents in new ways may reduce their negative effects on the heart.

Fortunately, with the ongoing advances in cancer treatment we are seeing improved survival of cancer patients. However, heart disease prior to, during or after cancer treatment can impact outcomes. We need to be successful in treating both cancer and heart disease...Additionally we hope this paper drives even more interest in the field so we can continue to see the development of more training programs, research and guideline development in the field of cardio-oncology."
Dr Laxmi Mehta, Cardiologist at The Ohio State University Ross Heart Hospital

Sources:

Mehta LS. et al Cardiovascular Disease and Breast Cancer: Where These Entities Intersect A Scientific Statement From the American Heart Association. Circulation. 2018;137.

https://www.eurekalert.org/pub_releases/2018-02/m-nfo013118.php