The connection between the breast and heart in a woman: Breast cancer and cardiovascular disease

Abstract

Cardiovascular disease remains the leading cause of death in women in the United States and is a major public health issue for all women, but it is of increasing concern to breast cancer survivors. Advancements in early detection and breast cancer therapy have resulted in over 90% of women surviving 5 years past their diagnosis of breast cancer. Nonetheless, with increased survivorship from breast cancer, there has been an increase in cardiovascular disease in these women. The consequences of the treatments for breast cancer may increase the risk for cardiovascular disease. Additionally, there is an overlap of risk factors common to both breast cancer and cardiovascular disease. The increased risk of cardiovascular disease in women who survive breast cancer must be recognized, with a focus on the prevention and early detection of cardiovascular disease.

Keywords: Acute Coronary Care; Acute Coronary Syndrome; Breast Cancer; Cardiovascular Disease.

Figure 1

A schematic representation describing the “multiple‐hit” hypothesis. At diagnosis, a significant proportion of early breast cancer patients present with preexisting or heightened cardiovascular disease (CVD) risk factors, which increase the risk of adjuvant therapy–associated cardiovascular injury. Independently, many adjuvant therapies used in breast cancer are associated with unique and varying degrees of direct adverse effects on the cardiovascular system. These direct effects occur in the context of concomitant lifestyle perturbations (indirect effects) that combine to reduce cardiovascular reserve. Collectively, these changes may leave the patient more susceptible to further cardiovascular insults and at higher risk of premature death due to cardiovascular mortality. From: Jones et al.,9 with permission

Figure 2

The impact of cancer treatment and cardiovascular risk factors on breast cancer survivors impacting the development of heart disease. Cancer treatment that can impact cardiovascular risk depicted in white. Nonmodifiable cardiovascular risk factors depicted by lines. Modifiable cardiovascular risk factors depicted by dots