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. 2017 Aug;164(3):537-555.
doi: 10.1007/s10549-017-4282-9. Epub 2017 May 13.

Risk of death from cardiovascular disease following breast cancer: a systematic review

S A M Gernaat  1 , P J Ho  2 , N Rijnberg  3 , M J Emaus  4 , L M Baak  5 , M Hartman  6 , D E Grobbee  7 , H M Verkooijen  4
Affiliations

Risk of death from cardiovascular disease following breast cancer: a systematic review

S A M Gernaat et al. Breast Cancer Res Treat. 2017 Aug.

Abstract

Purpose: Breast cancer incidence and survival is high, which results in high prevalence of breast cancer survivors. The risk of (death from) cardiovascular disease (CVD) is higher in patients exposed to cardiotoxic treatments, in particular if they have pre-existing CVD risk factors. This study systematically summarized the risk of death from CVD following breast cancer.

Methods: Databases of Medline, Embase, and the Cochrane Library were systematically searched using the following terms and synonyms: breast cancer, cardiovascular disease, and cause of death. Articles reporting on both risk and risk factors of CVD mortality following breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the Newcastle Ottawa quality assessment scale for cohort studies.

Results: Fourteen articles were included assessing the risk of CVD mortality among 1,217,910 women with breast cancer. The methodological quality was high for the majority of the studies. Studies were heterogeneous in design, study population, length of follow-up, CVD outcomes, and risk factors. 1.6-10.4% of all women with breast cancer died of CVD. Women with breast cancer had a higher risk of CVD mortality than women from the general population. The risk of CVD mortality was higher among women with breast cancer with older age at diagnosis, left-sided tumor, diagnosis in an earlier calendar period, and black ethnic origin.

Conclusions: CVD is an important cause of death following breast cancer. Identification of patients at high risk of CVD is important to optimize CVD prevention and tailor breast cancer treatment.

Keywords: Absolute risk; Breast cancer; Cardiovascular disease; Risk factors.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study format, informed consent is not required. This article does not contain any studies with human participants or animals performed by any of the authors.

Figures

Fig. 1
Fig. 1
Flowchart of the systematic review on the risk of death from cardiovascular disease in breast cancer patients
Fig. 2
Fig. 2
Quality assessment by the Newcastle Ottawa Quality Assessment Scale Selection was based on the representativeness of the breast cancer cohort and ascertainment of breast cancer. Comparability was based on the comparability of cohorts on the basis of the design or analysis. Outcome was based on the assessment of death from cardiovascular disease, on the length of follow-up (≥10 years), and adequacy of follow-up of the cohorts. A high score on one of these sections indicated that the maximum score on that particular section (i.e. two for selection and comparability, and three for outcome) was achieved. In all other cases, the study received a low score on that particular section
See this image and copyright information in PMC

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