Association of cancer treatment with excess heart age among five-year young breast cancer survivors.

IF 3.1 2区医学 Q2 ONCOLOGY

Journal of Cancer Survivorship Pub Date : 2024-07-15 DOI:10.1007/s11764-024-01645-9

Jacqueline B Vo, Shoshana Rosenberg, Bessie X Zhang, Craig Snow, Greg Kirkner, Philip D Poorvu, Rachel Gaither, Kathryn J Ruddy, Rulla M Tamimi, Jeffrey M Peppercorn, Lidia Schapira, Virginia F Borges, Steven E Come, Anju Nohria, Ann H Partridge

{"title":"Association of cancer treatment with excess heart age among five-year young breast cancer survivors.","authors":"Jacqueline B Vo, Shoshana Rosenberg, Bessie X Zhang, Craig Snow, Greg Kirkner, Philip D Poorvu, Rachel Gaither, Kathryn J Ruddy, Rulla M Tamimi, Jeffrey M Peppercorn, Lidia Schapira, Virginia F Borges, Steven E Come, Anju Nohria, Ann H Partridge","doi":"10.1007/s11764-024-01645-9","DOIUrl":null,"url":null,"abstract":"Purpose: Data evaluating cardiovascular disease (CVD) risk by cancer treatment among young women (≤ 40 years) with breast cancer are limited.Methods: Among 372 five-year breast cancer survivors aged 30-40 years from the Young Women's Breast Cancer Study, we assessed the association of cancer treatments (anthracyclines, trastuzumab, radiation/laterality, endocrine therapy) and excess heart age (difference between predicted 10-year CVD risk as assessed by adapted Framingham Risk Score and chronological age), prevalent elevated excess heart age (≥ 2 years), and worsening excess heart age (change of ≥ 2 excess heart age years) at breast cancer diagnosis and two- and five-year follow-up using multivariable linear and logistic regressions.Results: Most women had stage I or II (79%), ER + (71%), or PR + (65%) breast cancer. At diagnosis, women had little excess heart age by treatment receipt (range of means = -0.52,0.91 years). Left-sided radiation (β = 2.49,SE = 0.96,p = 0.01) was associated with higher excess heart age at five-year follow-up. For prevalent elevated excess heart age (two-year = 26%;five-year = 27%), women treated with right-sided radiation had increased risk at two-years (OR = 2.17,95%CI = 1.12-4.19), yet at five-years, associations were observed after any radiation (OR = 1.92,95%CI = 1.09-3.41), especially after left-sided (OR = 2.13,95%CI = 1.09-3.41) radiation. No associations were observed between systemic treatments and prevalent elevated excess heart age or any treatments with worsening excess heart age.Conclusions: Among young breast cancer survivors, radiation, but not other cancer treatments, was associated with elevated excess heart age.Implications for cancer survivors: CVD risk tools that incorporate cancer treatment, such as radiation, are needed to identify high risk young breast cancer survivors given the long survivorship and long latency of cardiovascular disease.","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Survivorship","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11764-024-01645-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Data evaluating cardiovascular disease (CVD) risk by cancer treatment among young women (≤ 40 years) with breast cancer are limited.

Methods: Among 372 five-year breast cancer survivors aged 30-40 years from the Young Women's Breast Cancer Study, we assessed the association of cancer treatments (anthracyclines, trastuzumab, radiation/laterality, endocrine therapy) and excess heart age (difference between predicted 10-year CVD risk as assessed by adapted Framingham Risk Score and chronological age), prevalent elevated excess heart age (≥ 2 years), and worsening excess heart age (change of ≥ 2 excess heart age years) at breast cancer diagnosis and two- and five-year follow-up using multivariable linear and logistic regressions.

Results: Most women had stage I or II (79%), ER + (71%), or PR + (65%) breast cancer. At diagnosis, women had little excess heart age by treatment receipt (range of means = -0.52,0.91 years). Left-sided radiation (β = 2.49,SE = 0.96,p = 0.01) was associated with higher excess heart age at five-year follow-up. For prevalent elevated excess heart age (two-year = 26%;five-year = 27%), women treated with right-sided radiation had increased risk at two-years (OR = 2.17,95%CI = 1.12-4.19), yet at five-years, associations were observed after any radiation (OR = 1.92,95%CI = 1.09-3.41), especially after left-sided (OR = 2.13,95%CI = 1.09-3.41) radiation. No associations were observed between systemic treatments and prevalent elevated excess heart age or any treatments with worsening excess heart age.

Conclusions: Among young breast cancer survivors, radiation, but not other cancer treatments, was associated with elevated excess heart age.

Implications for cancer survivors: CVD risk tools that incorporate cancer treatment, such as radiation, are needed to identify high risk young breast cancer survivors given the long survivorship and long latency of cardiovascular disease.

Abstract Image

查看原文本刊更多论文

癌症治疗与五年期年轻乳腺癌幸存者心脏超龄的关系。

目的：评估年轻女性（40 岁以下）乳腺癌患者因癌症治疗而患心血管疾病（CVD）风险的数据非常有限：在 "年轻女性乳腺癌研究"（Young Women's Breast Cancer Study）的 372 名 30-40 岁的五年期乳腺癌幸存者中，我们评估了癌症治疗（蒽环类药物、曲妥珠单抗、放疗/化疗、内分泌治疗）与超常心脏年龄（通过改编的弗雷明汉风险评分评估的预测 10 年心血管疾病风险与实际年龄之间的差异）之间的关系、使用多变量线性回归和逻辑回归分析乳腺癌诊断时以及随访两年和五年时的普遍超常心龄升高（≥ 2 岁）和超常心龄恶化（超常心龄变化≥ 2 岁）。结果显示大多数妇女患有 I 期或 II 期乳腺癌（79%）、ER +（71%）或 PR +（65%）。在确诊时，妇女的心脏年龄几乎没有因接受治疗而增加（平均年龄范围 = -0.52,0.91岁）。左侧放射（β = 2.49,SE = 0.96,p = 0.01）与五年随访时较高的超常心脏年龄有关。对于普遍升高的超常心龄（2 年 = 26%；5 年 = 27%），接受右侧放射治疗的妇女在 2 年时风险增加（OR = 2.17，95%CI = 1.12-4.19），但在 5 年时，任何放射治疗后（OR = 1.92，95%CI = 1.09-3.41），尤其是左侧放射治疗后（OR = 2.13，95%CI = 1.09-3.41），均可观察到相关性。在系统治疗与普遍升高的超重心脏年龄之间，或任何治疗与恶化的超重心脏年龄之间，均未观察到任何关联：结论：在年轻的乳腺癌幸存者中，放射治疗（而非其他癌症治疗）与超重心脏年龄升高有关：对癌症幸存者的启示：鉴于年轻乳腺癌幸存者的存活期较长，心血管疾病的潜伏期也较长，因此需要结合癌症治疗（如放射治疗）的心血管疾病风险工具来识别高风险的年轻乳腺癌幸存者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Cancer Survivorship ONCOLOGY-

CiteScore

7.00

自引率

10.80%

发文量

149

审稿时长

>12 weeks

期刊介绍： Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.