“For older women, (cardiovascular disease) poses a greater mortality threat than breast cancer itself. This is the first scientific statement from the American Heart Association on CVD and breast cancer,” the statement says.
“We are still recommending that patients do get their breast cancer treatment. They should get the best treatment that’s necessary for their breast cancer,” she said, but patients should try to prevent or reduce those risks to their heart health by maintaining a healthy diet, exercising, and monitoring their blood pressure and cholesterol.
“We have taught and seen these problems. The report may bring this problem to the front of mind among emergency medicine and internal medicine doctors who are caring for these women,” he said. “Let’s give these drugs and treatments to people who need them — the risk-benefit is more favorable — and let’s do all we can to determine who is unlikely to benefit from the drugs and spare them the risks.”
The new statement noted that radiation and chemotherapies can pose a risk to cardiovascular health.
The study involved 2,168 women who underwent radiotherapy for breast cancer between 1958 and 2001. It showed that the rate of major coronary events among the women increased 7.4% for each additional gray, or unit, in the average radiation dose delivered to the heart.
Women irradiated for cancer of the left breast, near the heart, had higher rates of major coronary events than women irradiated for cancer of the right breast, the study found.
“It is less a problem today than 20 years ago, because we started aiming the beam to miss the heart about 20 years ago, but we occasionally see a woman who had lumpectomy and radiation, and the radiation beam caught part of the heart and a coronary artery,” Brawley said. “This can cause isolated coronary artery disease in that portion of the artery.”
“Radiation therapy does have that risk of developing coronary artery disease, and it can be several years to a decade or more later,” Mehta said.
“Adriamycin, or doxorubicin, and trastuzumab, or Herceptin, are the big causes of heart failure,” Brawley said.
“Adriamycin-induced congestive heart failure symptoms can show up three to five years after treatment and easily be missed by an internist or ER doctor who does not see a lot of these patients,” he said. “Health care is changing such that a cancer patient often does not see an oncologist after completion of therapy.”
In general, the impact of both cardiovascular disease and breast cancer among women can be significant, and Mehta hopes the new statement raises this awareness, especially among older women.
“Older breast cancer survivors are more likely to die from other diseases and not breast cancer, and cardiovascular disease is the most frequent cause,” she said.
Overall, “one of the great things about the cancer world right now is that there are more and more survivors,” Mehta said.
“Oncologists are doing a terrific job of increasing survival rates by advancing the science and improving cancer treatments. This is much better than a few decades ago,” she said. “But there are side effects from these cancer treatments, and we’re trying to recognize it in the very early phases so that we may be able to mitigate the heart effects and avoid significant heart damage.”
News credit : Cnn