High prevalence of CV conditions among male breast cancer patients
Research presented at the American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient found that male breast cancer patients had a high prevalence of CV conditions.
“Due to the rarity of male breast cancer, there are no cardiovascular data from larger clinical trials or population studies,” Michael Ibrahim, medical student at Georgetown University, Washington, D.C., said in a press release. “The lack of data makes it even more important to individualize cardiovascular assessment and management based on each patient’s unique oncologic, therapeutic and preexisting cardiovascular risk profile to support them through cancer treatment into survivorship.”
The retrospective chart review included 24 male breast cancer patients aged 38 to 79 years evaluated at MedStar Washington Hospital Center and Georgetown Lombardi Comprehensive Cancer Center. Researchers collected baseline characteristics, cancer diagnosis and treatment, CV risk factors, comorbidities, cardiac diagnostic study results and cardiac events to assess the relationship between CVD and male breast cancer.
Half of the cohort had a family history of breast cancer and 79% of patients had invasive ductal carcinoma, the most common breast cancer, and 21% had ductal carcinoma in situ. All patients underwent a mastectomy with 71% receiving hormone therapy, 17% receiving anthracycline chemotherapy, 16% receiving radiation and 8% receiving HER2-targeted therapy. Second primary malignancy was diagnosed in 25% of patients and third primary malignancy was diagnosed in 13% of patients.
When evaluating CV risk factors and comorbidities, researchers found that 88% of patients were overweight, 58% had hypertension and 54% had hyperlipidemia. Eight percent of patients had preexisting tachyarrhythmias and 13% developed tachyarrhythmias during treatment.
Researchers noted a decrease in ejection fraction in two patients during treatment, whereas two patients developed HF after treatment.
According to the researchers, further investigation is needed to fully understand the risk for preexisting CVD on long-term outcomes as well as the cardiotoxic effects of chemoradiation among this cohort.
“The field of cardio-oncology is well positioned to ensure that cardiologists and oncologists work closely together to address both the patients’ oncologic and cardiac concerns,” Ibrahim said in the release. “Cardio-oncologists or cardiologists should pay close attention to the proposed treatment plan and be part of a multidisciplinary cancer care team to evaluate the patients’ cardiovascular risk prior to and through cancer treatments. Similar to the pretreatment consultation with radiation oncology, breast surgery and medical oncology, an upfront cardiovascular risk assessment provides greater comfort and further minimizes psychological surprise with cardiovascular complications going into cancer treatment.”
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Ibrahim M, et al. Basic Science in Cardio-Oncology (fundamental or bench research). Presented at: American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient; Feb. 5-6, 2021 (virtual meeting).
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